CHENNAI: Chennai-based Aditya Dinesh’s decision to register with DATRI, a blood stem cell donor registry in the city, and his subsequent decision to donate his bone marrow twice in 2016 did a miracle in a four-year-old boy’s life in Bengaluru. The kid was one of the lucky few to find a match. Unfortunately, many patients don’t. Since World Marrow Donors Day falls on the third Saturday every September, which is today, CE looks at the importance of bone marrow donation, and what it means to someone in a battle for life against death.
“Stem cell therapy uses the potential of cells to regenerate and repair damaged tissues. For more than 30 years, stem cell therapy has been used successfully for conditions like leukaemia (blood cancer), sickle cell anemia and beta thalassemia; immuno deficiency disorders like Whiskott Aldrich Syndrome, metabolic disorders, and even cancers like multiple myeloma, neuroblastoma and over 100 other diseases,” says Dr Kasi Vishwanathan, Meenakshi Mission hospital, Madurai.
How it helps
Chennai has two major registries — DATRI and JEEVAN — where you can register as a donor. These registries collect samples of HLA (human leukocyte antigen) from volunteers, who are then registered in their database. A registered donor is approached by the registry if he or she is matched to a patient.
One of the patients who benefitted from a stem cell donation was six-year-old Fateh Singh. He was diagnosed with thalassemia as a toddler. His mother Harpreet Kaur Sethi chokes up when she says, “My son is alive because of a decision made by a noble donor. I am at a loss of words to express my gratitude. I urge everyone to register for donation.” Fateh is on medication but is enjoying his childhood as a normal kid.
W Vimal Fernandes, who donated in 2015, says he will not hesitate to donate regularly. “If a simple and harmless decision can save a life, why should we think twice about it? I am lucky to be a donor and thank god for the opportunity. I will definitely donate to anyone if I am matched again.”
What’s HLA?
“HLA is a protein found on most of the cells in a persons body. The immune system uses HLA markers to determine which cells belong to your body and which do not. We use it to find out how closely tissues of one person match another,” says Dr Deenadayalan, Global Health Centre, Perumbakam.
To find a match, an HLA match is crucial. “Since ethnicity plays a major role in HLA matching, our database has community and ethnicity-based drives as well,” says Raghu Rajagopal, CEO, DATRI. It conducted its third cycle marathon from Taramani to Maha-balipuram recently.
“Raising awareness about the safety and benefits of registering for stem cell donation is vital because over 90%of patients do not find a match. The expansion of the registry will give them a better chance,” says Dr P Srinivasan, co-founder of JEEVAN.
How it works
More often than not, when a child requires stem cell donation, parents are advised to have another kid. Why? “That’s because there is a 50% chance of your sibling being an HLA-identical match to you. But not a lot people are able to find a match within the family, and that’s why a lot of them end up on the registry seeking help from strangers,” explains Dr Kasi.
The general public, however, is ignorant about it and apprehensive when they hear terms like bone marrow harvest and stem cell donation. Explaining the process, Dr Madan of SRM Institute of Medical Science, Vadapalani, says that there are two ways of donating stem cells. “One by harvesting directly through the blood, which is a non-surgical process. And the second is performed under full anaesthesia, and yes, it’s a surgery,” he explains. “In the former, we give an injection to the donor five days before the donation to increase the stem cell count. A machine is used to harvest the stem cells while the blood is returned to the donor.”
Explaining the surgical process, Dr Revathy Raj of Apollo Hospital, Teynampet, says, “It involves collection of stem cells by piercing the marrow of the hip bone or sternum with a needle. A sternum is a long, narrow, flat plate that forms the center of the front of the chest. You will be in pain for a few days after the procedure.”
Aditya Dinesh who has donated twic, says, “The short-lived discomfort is dwarfed by the fact that you are saving a life. I am honoured to have had the opportunity twice and will continue to do so.” Cost of the entire process is borne by the registries
There are several risks you take while being under anaesthesia but a lot of doctors still choose a surgical procedure. Why? “Most doctors I know do not make that decision easily. It depends on the age of the donor and also their health conditions. If they have a risk of graft or any other disease, we have to reject the donated cells,”explains Dr Revathy. Young donors, who are relatives or siblings, cannot be placed on the machine that draws blood. Hence we opt for marrow harvest.”
Bone Marrow Aspiration and Biopsy
Precautions
(by Dr Kasi Vishwanathan, Meenakshi Mission Hospital, Madurai)
Before donation
Follow a balanced diet and exercise to stay fit
Avoid drinking and smoking
Ensure you have no major illnesses or active infection (diabetics or hypertension patients with conditions under control can donate)
After donation
Take paracetamol for mild flu-like symptoms but avoid anything with aspirin as it hinders clotting of the blood
Apply ice pack on the lower back to reduce swelling in the case of bone marrow donation
Continue to eat small balanced meals.
Avoid heavy lifting
Sleep early
Take adequate rest
Registrations for DATRI can be done through www.datri.org and with JEEVAN through www.bethecure.in