Every year, thousands of people across the globe are diagnosed with both malignant and non-malignant disorders of the blood and immune system, as well as metabolic diseases. Many of these cases reach a stage where a stem cell transplantation is their only hope of survival. It is for this reason that DKMS has 10,7 million donors registered its stem cell registry, with 70,000 of these having gone on to donate to patients worldwide. In South Africa, DKMS Africa, formerly known as the Sunflower Fund, is seeking to drive awareness on how technology has made becoming a donor quick and easy in order to grow the local registry.
Alana James, country executive director at DKMS Africa, says this is vital as the chances of having a fully matched sibling donor are only 25 percent for every patient. Although patients of European ancestry are likely to increase the likelihood of finding a match on a national or international registry to upwards of 80%, this is not the case for patients of African or mixed-race ancestry. In the latter patients, donors are found in less than 20 percent of cases. Reasons for this discrepancy are the significant genetic diversity that exists in African populations compounded by the lack of African and mixed-race donors on registries. People living with blood diseases in South Africa are thus at a distinct disadvantage. Alana adds “as such, we need to recruit local donors so we can save more lives.”
Thanks to medical and technological advances, James explains that donors and patients are now matched via more sophisticated typing of the Human Leukocyte Antigen (HLA) region in the DNA. The sample for this complex testing is in the form of a simple cheek swab from both the patient and the potential donor. “This is much more complex than matching blood groups.”
Following the Sunflower Fund’s merger with DKMS, the organisation now has access to the DKMS Life Science Lab which became the world’s first HLA typing Lab in 2013. “The lab utilises breakthrough Next-Generation Sequencing technology which has resulted in over 1 million potential stem cell donors currently typed per year,” she says.
“We are now able to provide the most efficient and detailed donor selection process ensuring that every patient in need of a transplant is able to find the most suitable donor as quickly as possible,” adds James. However, she points out that the odds of being a match are about 1: 100 000 which is why the organisation needs as many donors as possible.
Explaining the reasons why people may be reluctant to become a donor, James notes that “they believe that the process of harvesting stem cells directly from bone marrow is most commonly practiced.” Again, innovation in the medical and technological spheres have allowed this process to become streamlined and relatively pain-free. “90 percent of the time, stem cells are harvested from one’s blood.”
Outlining this process, James says that once matched, the donor will receive injections to stimulate release of their blood stem cells which are present in the bone marrow, into the bloodstream. “For the actual donation, a needle is placed into one arm and the donor’s blood is circulated through an apheresis machine. This machine acts as a filter to remove the blood stem cells and then the remaining blood is returned through a venous line in the other arm. “The whole process takes approximately 4-6 hours and you can return to work within one or two days.”
There is no cost to individuals to become donors, as DKMS Africa covers the cost of the DNA test required to register as a donor. There is also no cost to donate stem cells when you are identified as a match for a patient.
If you are aged 18-55 and are in general good health, you can register as a stem cell donor. It’s simple and easy and has the potential to change the lives of patients for whom no other choice exists.