For those diagnosed with life-threatening blood disorders like leukemia, lymphoma, aplastic anemia, or specific genetic diseases, a bone marrow transplant may be the sole curative option. Nonetheless, the success of a transplant largely hinges on locating a suitable match for bone marrow donation, this task can be difficult, but it is achievable.
This blog delves into the science, strategy, and support related to finding a bone marrow donor match, equipping patients and families with essential knowledge for their critical journey.
The spongy tissue found within bones, known as bone marrow, is responsible for producing blood-forming cells. A bone marrow transplant, also referred to as a hematopoietic stem cell transplant, is required to replace diseased or damaged marrow with healthy stem cells.
There are two main kinds of transplants:
In cases where an allogeneic transplant is required, it is vital to locate a compatible donor in order to lower the likelihood of complications such as graft-versus-host disease (GVHD) and to enhance the probability of a successful transplant.
Finding a suitable bone marrow donor involves more than just matching blood types; it necessitates a close alignment of specific genetic markers. Grasping the factors that constitute a donor match is essential for maximizing transplant success and reducing complications.
The human leukocyte antigen (HLA) system holds the key to finding a donor match. HLAs are proteins, also known as markers, that are present on the majority of your body's cells. The immune system employs these markers to identify cells that are part of your body and those that are not.
A blood test or cheek swab is used to perform HLA matching by comparing the patient’s HLA markers with those of potential donors. Five key HLA markers are taken into account for matching (HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1), with a 10/10 match being regarded as the ideal scenario.
Due to the inheritance of HLA markers, siblings of the patient (particularly full siblings) have the highest probability of being compatible. There is about a 25% chance that a sibling will be a perfect HLA match.
If there is no sibling match, the search broadens to include unrelated donors from registries.
The process of finding a suitable bone marrow donor starts with a careful coordination that involves understanding your genetic markers and examining different donor sources. The essential steps that assist patients and healthcare teams in the process of finding a suitable match are outlined below.
The process begins with HLA typing of the patient. A transplant center carries this out, and it serves as the foundation for all donor searches. The patient’s HLA profile will serve to:
Family members of the test
Look through registries of unrelated donors
Investigate alternative choices such as cord blood
After determining the patient’s HLA type, tests are conducted on immediate family members (siblings, parents, and children). As previously noted, the probability of matching is greatest among full siblings, whereas parent-child pairs are generally half-matches (haploidentical).
When a fully matched sibling is found, they are often the preferred donor.
If no relatives match, physicians will begin searching through global bone marrow donor registries. The following registries are included:
These databases enable transplant centers to look for volunteer unrelated donors who have signed up to donate bone marrow or stem cells.
In the absence of an immediate donor, umbilical cord blood can be taken into account. Units of cord blood, which are gathered at the time of birth and kept in public repositories, hold stem cells and need not comply with as rigorous HLA matching. Even though the cell count is lower (which could restrict its use in adults), it continues to be a viable option for many patients, particularly children.
In certain situations, a haploidentical (half-matched) family member can act as a donor. With the progress in transplant medicine, haploidentical transplants have become safer and more effective, thereby expanding the donor pool.
It is not always easy to find a suitable bone marrow donor. Even with progress in medical technology and the expansion of registries, various obstacles like genetic diversity and inadequate donor representation can complicate and accelerate the quest for an ideal match.
Since HLA types are passed down through ethnicity, an individual’s ethnic background can greatly influence their likelihood of finding a match. As an example, individuals from mixed racial or minority ethnic backgrounds may struggle more with finding a match due to the rarity of their HLA types in worldwide registries.
Although there are millions of registered donors globally, many areas still lack adequate representation in registries. For instance, nations such as India have low registration rates relative to their population, complicating the search for South Asian patients.
Finding a match relies significantly on volunteer donors. This is how you can contribute to a change:
Generally, anyone aged 18 to 50 (the exact age range may differ slightly by country) can join a registry. It's easy to register, only a cheek swab or blood test is needed. If you ever match, you might be asked to provide stem cells through:
Numerous individuals do not realize that enlisting in a registry could be life-saving. Donor diversity can be enhanced and global matching rates improved by sharing information, organizing drives, or raising funds for donor registries and public cord blood banks.
Often, patients and their relatives initiate personal campaigns in search of a donor. These campaigns can be amplified through social media or community outreach, which can significantly enhance the likelihood of success.
Related: Preparing for a Bone Marrow Transplant: What Patients Need to Know
Finding a matching bone marrow donor involves medical precision, global collaboration, and human generosity. This serves as a strong reminder of our biological connection and that saving a life can be as easy as registering and waiting for the call.
For patients and families confronting this overwhelming process, hope exists. The future of bone marrow transplantation is becoming increasingly promising due to heightened awareness, improved matching techniques, and greater donor involvement.
We at L H Hiranandani Hospital recognize that a bone marrow transplant can be a transformative procedure fraught with difficulties. Our team of specialists in transplantation collaborates with top national and international registries to assist patients in locating the most suitable donor match. We are dedicated to providing compassionate and comprehensive care tailored to your unique needs, from diagnosis through transplant and recovery.
If you or someone dear to you requires a bone marrow transplant, contact our specialists today.
The opportunity varies based on ethnicity and the matches that are available in global registries. In patients of European descent, the odds may range from 70 to 80 percent. For other ethnic groups, it may be much lower.
Bone marrow is usually donated under anesthesia, and the procedure is safe. Today, the more prevalent method is PBSC donation, akin to blood donation and resulting in minimal discomfort.
This is contingent on the circumstance. Chronic conditions such as diabetes or hypertension can be deemed acceptable if they are managed effectively. However, individuals suffering from cancer, autoimmune disorders, or infectious diseases might not qualify.
