Every 5 minutes, someone in India is diagnosed with blood cancer and many of them children and young people. Those who can’t be treated with chemotherapy need a successful blood stem cell transplant from a matching donor for a second chance at life
Kriti, a 22-year-old girl who was diagnosed with blood cancer when she was 12-year-old and is on medication for the last 10 years. She has been struggling to survive each day but has now reached a point where a stem cell transplant is her only chance at survival. Her stem cell transplant will only be possible if she finds a matching blood stem cell donor.
Bangalore-based DKMS BMST Foundation India, part of Deutsche KnochenMarkSpenderdatei” or “German Bone Marrow Donor File”) international nonprofit bone marrow donor center based in Germany, is dedicated to the fight against blood cancer and other blood disorders, such as thalassemia and aplastic anemia.
Curriculum magazine in support welcomes Patrick Paul, CEO of DKMS BMST Foundation India for raising awareness among the student community in India and spread correct information on stem cell donation
What is blood cancer and its incidence in India?
Blood cancer refers to defects in the blood-forming system, which cause cancer cells to enter the bloodstream and multiply uncontrollably, crowding out the healthy cells. In patients suffering from blood cancer or other blood disorders, they have defects in the blood-forming (hematopoietic) system. This stops the normal process of cell maturation leading to the formation of immature or dysfunctional blood cells.
Blood cancer and blood disorders like Thalassemia and Aplastic Anemia are on the rise and every 5 minutes, someone in India is diagnosed with the disease. Many patients are children and young people whose only chance of recovery is a stem cell transplant. As per the Globocan 2020 reports, every year over 70 thousand people die of blood cancer and over 1 lakh people are diagnosed with a form of blood cancer of blood disorders in India.
In which condition is stem cells transplant used to treat blood cancers?
Most often blood cancer can be treated by administering chemotherapy. However, for patients who cannot be treated with chemotherapy, their only hope of survival is through a blood stem cell transplant.
A blood stem cell transplant infuses healthy blood stem cells from a matching donor to the patient. Lymphoma, Leukemia, Myeloma and Hodgkin disease & other blood disorders such as Aplastic Anemia & Thalassemia can be treated with a blood stem cell transplant. A successful blood stem cell transplant in 70% to 90% of these patients may give them a second chance at life, depending on the disease condition and the donor type.
Both malignant and non-malignant conditions can be treated with a blood stem cell transplant, including Lymphoma, Leukemia, Myeloma and Hodgkin disease & other blood disorders such as Aplastic Anemia & Thalassemia. Sometimes, the only treatment option for survival of a blood cancer patient is with a blood stem-cell transplant.
Importantly, there is a possibility of finding the perfect match from a donor of the same ethnicity. Only about 30% of the patients can find a sibling match and the rest 70% depend on finding a matching unrelated donor.
Can you explain the technique involved in donation of blood stem cells?
Blood stem cell donation is similar to blood platelet donation. Blood stem cells are donated through the Peripheral Blood Stem Cell donation (PBSC) method. This involves the doctor placing a special intravenous line in each arm’s vein. In the run-up to the procedure, donors are given a drug called Granulocyte Colony Stimulating Factor (G-CSF) for a period of five days. G-CSF occurs naturally in the body and increases the number of stem cells that are produced in the bone marrow and flushed into the bloodstream. While taking the injections, the donor may feel flu-like symptoms, but these will disappear after the donation and there are no known long-term side effects of this injection.
On the day of donation, the donor’s blood is collected from one arm, using a sterile, disposable kit and passed through a machine that separates out the increased number of blood stem cells. The remaining blood is routed back to the donor through the other arm. This is a very safe, non-surgical outpatient procedure that takes approximately three to five hours to complete at the most, and donors can normally leave the collection center on the same day.
Who can donate blood stem cells and what is the procedure of donating the blood stem cell?
Any adult between the ages of 18 and 50 and in general good health can register as a potential blood stem cell donor. When a potential donor registers with us, their cheek swab samples are sent to the DKMS Life Science Lab in Dresden, Germany for testing. At the lab, the sample is analyzed to determine the HLA (Human Leukocyte Antigens) characteristics – a fairly complex procedure that can take up to six weeks. After the HLA has been typed, the data is stored confidentially and made available in an anonymous form via the DKMS registry and registries around the world, via the World Marrow Donor Association. Transplant physicians search these registries for matching donors for their patients.
When someone comes as a match, they donate blood stem cells via peripheral blood stem cell collection process (PBSC). This process is similar to a blood platelet donation. Donor’s blood is collected from one arm, using a sterile, disposable kit and passed through a machine that separates out the increased number of blood stem cells. The remaining blood is routed back to the donor through the other arm. This is a very safe, non-surgical outpatient procedure that takes approximately three to five hours to complete at the most, and donors can normally leave the collection center on the same day.
When blood stem cells are collected from a donor, they are infused into the patient through a transplant process which then moves through the bloodstream and settle in the bone marrow. These new blood stem cells begin to increase in numbers and produce red blood cells, white blood cells and platelets, resulting in the replacement of the patient’s diseased cells.
How do you incentivize youth participation and are there any institutional arrangements in terms of clubs etc.?
We are associated with various major corporates, clubs such as Rotary club, Medical associations. We have a student ambassador program in place, in this we have students from various college join us as student volunteers. We organize numerous webinars, volunteering sessions are being conducted with corporates, colleges this includes HCG group of hospitals, Oracle, Collins Aerospace, Volunteer for a Cause, Rotaract, Government Engineering college, Kozhikode to name a few.
What would be your message to youth of India?
Ethnicity plays a key role in finding the perfect match. Patients and donors of Indian origin have unique HLA characteristics that are severely under-represented in the global database, which makes the probability of finding a suitable donor even more difficult.
Due to this under-representation, it is extremely difficult for Indian patients to find a matching unrelated donor. This situation can only be changed by recruiting many potential stem cell donors from India.
Amidst the Corona crisis, we should not forget that there are still lakhs of patients in India who are suffering from Blood Cancer and other blood disorders like Thalassemia and Aplastic Anemia and they need our support. These patients need a stem cell transplant to get a second chance at life. For a successful stem cell transplant, blood stem cells from a matching donor are required and 70% of the patients are dependent on an unrelated donor. We encourage people to please come forward and register online as a potential lifesaver. People who are interested and fit the eligibility criteria can register at: www.dkms-bmst.org/register
Give you please give us an overview of DKMS-BMST?
DKMS-BMST is dedicated to the fight against blood cancer and blood disorders by: creating awareness, recruiting blood stem cell donors to provide a second chance at life, raising funds to match donor registration costs, and supporting the improvement of blood cancer therapies by our own research.
We also support patients from day one of their diagnoses, providing family and friends with a positive way to get involved by organizing donor registration drives that can enhance a donor search, rally community support and provide hope. Globally DKMS has over 10.5 Million registered and has helped over 90000 patients with a second chance at life.
DKMS globally believes, it is crucial to remove both socio-economic and as infrastructural barriers so that more patients are able to access potentially life-saving therapy. Consequently, we are always striving to find new ways to facilitate that – to save as many lives as possible.
Even for those patients who do get access to therapy and appropriate health care, this often results in heavy social and financial burdens on patients and their families. This is particularly the case in low- and middle-income countries like India. At DKMS, we are committed to alleviating this burden.
Our current activities to facilitate access to transplantation cover three main areas:
i.The DKMS Patient Funding Program to lessen the financial barriers of transplantation
This program intends to facilitate access to transplantation by contributing to the costs of the blood stem cell transplantation for patients, who would otherwise not receive treatment.
ii.The DKMS Free HLA Typing Program to identify family donors and to support donor searches
This program aims to identify family donors by carrying HLA typing costs for patients in need of a transplant and their family members. We also support unrelated donor searches for patients who do not find a suitable family donor.
iii.The DKMS Capacity Building Program to advance treatment and care through infrastructural support and knowledge sharing
This program focuses on making a sustainable contribution towards the enhancement of high-quality and affordable health care for patients with life-threatening blood diseases. This comprises funding for non-profit hospitals and organizations in countries with a shortage of resources, to help them deliver appropriate treatment as well as trainings for physicians and nurses to advance the level of care.