Childhood cancer remains a significant global health challenge, with over three lakh new cases reported annually. India contributes more than 50,000 of these cases, placing it among the countries with the highest burden. Leukaemia, the most common childhood cancer in India, accounts for about 30% of cases.
Adding to this burden is thalassemia, which impacts approximately 10% of global cases. These diseases, along with other conditions like sickle cell disease, bone marrow failure, primary immune deficiency disorders, and rare metabolic disorders represent a burden of diseases that require advanced treatment options.
Over the years, medical advancements have introduced transformative therapies, and one of the most impactful among them is stem cell therapy.
Stem cell therapy, also known as bone marrow transplantation (BMT), offers a life-saving treatment option. This procedure replaces diseased or damaged cells with healthy stem cells, restoring the body’s ability to produce blood cells. With survival rates exceeding 90% for transplants performed using fully matched sibling donors, BMT stands as one of the most effective cures available. However, the success of stem cell transplants depends on finding compatible donors, which is a significant challenge.
Challenges
India requires approximately one lakh transplants annually, yet only around 2,000 are performed due to the limited availability of compatible donors. One of the primary challenges contributing to this shortage is the low number of registered donors. India has only six lakh registered donors, and the chances of finding a match are low. Only 30% of patients find donors within their families, leaving the rest reliant on unrelated donors from registries, a resource India severely needs to improve.
Another significant challenge stems from India’s genetic diversity. Successful transplants rely on close genetic matches, and limited donor registries further complicate the search process.
Myths and misconceptions surrounding stem cell donation also contribute to the shortage. Many believe that donating stem cells is painful or harmful, discouraging potential donors. Limited public awareness about its safety and simplicity worsens the problem.
Financial constraints also play a critical role in the stem cell shortage. Stem cell transplants are expensive for many families. The cost of finding donors, acquiring stem cells, and undergoing the procedure creates an overwhelming financial burden.
Addressing the shortage
Promoting education and awareness about stem cell donation is crucial in overcoming the shortage. It should be emphasised that it is safe, easy, and minimally invasive. Partnerships with schools, healthcare providers, and community leaders can be formed to raise awareness and encourage donations. Expanding and diversifying donor registries are another critical solution. Building stronger donor registries, especially by including diverse ethnic groups, is vital to improving match rates.
Additionally, encouraging cord blood banking can be a viable strategy. Umbilical cord blood, a rich source of stem cells, can be easily collected during childbirth. Promoting public cord blood banks and encouraging donations can greatly increase stem cell availability.
Reducing financial barriers is also essential. Collaborations among governments, healthcare organisations, and non-profits can reduce financial burdens and provide free or low-cost registration programmes.
Dr Satya Prakash Yadav
(The author is director of Paediatric Hemato Oncology & BMT at Medanta, Gurugram)