by Eveline Gan
For more than a year, Jane Prior’s son, Daniel, grappled with unexplained on-and-off high fevers. By the time doctors nailed down the cause of the fevers, the 11-year-old was getting random bruises over his body.
The diagnosis: Acute myelogenous leukemia, an aggressive form of blood cancer. To survive, Daniel would require a bone marrow transplant.
Speaking at the Bone Marrow Donor Programme (BMDP) press conference last week, Jane told TODAY: “It would have been so easy for us if his siblings were a match but they weren’t. There wasn’t anything else to do but to wait for a match from someone else.”
Three months later, they found a matching donor from Australia. In 1996, Daniel became the first child to receive a successful bone marrow transplant from an unrelated donor at the National University Hospital.
Jane understands how nerve-wrecking the wait for a suitable unrelated bone marrow donor can be for patients and their loved ones. Presently the president of BMDP, the Singapore Permanent Resident now actively campaigns for the urgent need to expand Singapore’s bone marrow donor pool.
At the press conference last week, BMDP announced plans to expand the local register by a further 5,000 volunteer donors this year. There are currently about 50,000 donors in the non-profit organisation’s database.
Each year, 2 in 3 adults in Singapore suffering from various leukaemia and other deadly blood-related diseases will require a bone marrow or blood stem cell transplant in order to survive.
But the chance of finding a match from an unrelated donor is only 1 in 20,000, said Dr Yvonne Loh, haematologist and medical director of the Haematopoietic Stem Cell Transplant Programme at Singapore General Hospital (SGH).
Parents are usually not suitable donors for their children because each child inherits half his set of genes from each parent, explained Dr Loh. Siblings serve as the most suitable blood stem cell donor – the chance of a match is 1 in 4. But in more than 70 per cent of cases, this is not possible.
“In Singapore, our patients have access to the very best medical facilities, but with typically small families there is seldom a matching family member so we still lose lives unnecessarily when no matching donor can be found,” said Jane.
When a match cannot be found in the Singapore registry, the search will extend to other parts of the world. Finding a match typically takes about 15 weeks, but for minority ethnic groups, Dr Loh said the search “can go on for many months”.
Explaining why she volunteered at BMDP a year after her son’s transplant, Jane said: “I didn’t want anyone else suffering from the disease to be told that a match cannot be found simply because they belong to an ethnic minority group.”
As donor match is most likely to be found from within the same ethnic group, BMDP hopes to expand donor sign-ups in the minority groups.
Last year, Shalini Nair, 26, underwent a peripheral stem cell harvest to save a stranger’s life. The process took two days, for seven hours each.
“After the procedure, your life is back to normal but to someone else, your donation has changed their life,” she said. Eveline Gan
Sidebar: Becoming a donor – get your facts right.
Are you going to crack my spine or take a sample of my bone marrow? In her decade-long experience as a Bone Marrow Donor Programme volunteer, Jane Prior said that such misconceptions are still common. Haematologist Dr Yvonne Loh, medical director of the Haematopoietic Stem Cell Transplant Programme at the SGH, clears up the mystery surrounding the donation process.
Myth 1: It is a hassle to sign up as a donor because you’ll need a sample of my bone marrow.
All you’ll need to sign up as a volunteer donor is to provide a sample of your saliva using a buccal swab. The cotton-tip swab is used to collect DNA from the cells of your cheek. You can even arrange for the buccal swab to be sent to you via mail. The DNA information is then recorded in the registry, and you will be contacted to donate if you are found to be a match to a patient.
Myth 2: Bone marrow donation is risky.
If you are found to be a potential match for a patient, BMDP will contact you and arrange for a medical check-up and blood tests to confirm you are a match.
The donation process will be from the vein in your arm (stem cell harvest) or from the pelvic bone (bone marrow harvest). The latter is performed under general anaesthesia. According to Dr Loh, both are safe procedures and risks to donors are mild and rare. Within two weeks of donation, most donors’ blood cell counts would have returned to normal.
Myth 3: I can’t say no after signing up with the registry.
You have the right not to go ahead with the donation process, when you are successfully matched with a patient. However, once you give your consent on the “Intent to Donate” form (this is usually done after undergoing medical check-up and counselling), it is a life-and-death situation for the patient. The patient will undergo pre-transplant treatment which wipes out his bone marrow. If you pull out at this stage, he may die without a transplant.
Call 6327 1344 or visit www.bmdp.org for more information.