Treatment of medical conditions requiring transplants call for stem cell donations from family members such as siblings or donors with a matching tissue type. Lack of awareness on stem cell donation and fear of donation procedures among donors, often hinder the treatment progress for patients requiring matching stem cells.
A recent article on New Indian Express throws light on the fears and the opinions of medical practitioners:
“Men fear that bone marrow donation would affect their virility, while women are afraid of losing their fertility,” said Dr Shruthi Prem, associate professor of medical oncology, at RCC, Thiruvananthapuram.
“The serious nature of diseases like cancer, for which bone marrow transplantation is prescribed as a treatment, makes them too nervous to donate. It is the stem cell of siblings the gives the best result to the patient. Normally, even if the siblings are ready to donate, their spouses do not permit it due to fear. Besides, the donors usually brood on questions such as what would be the ramifications when they loose their stem cells?. The fact is that stem cells multiply infinitely, and within two to four days their count becomes normal,” she pointed out. “Across the country, there are around 60,000 registered donors, which is considerably low when compared to country’s population. It would not be sufficient even to treat 10 per cent of the patients. But, the main trouble is that after registration many of them back-off at the eleventh hour. Above all, people are not willing to donate if there is no emotional connection with the patient. In the West, there are around 14 billion donors who have come out in volition, which would be sufficient to treat 80 per cent of the patients,” she added.
When asked whether the procedure is 100 per cent safe, Dr Neeraj Sidharthan, associate professor at the stem cell transplant division of the AIMS, Kochi, said,” no medical procedures can be said to be 100 per cent safe. But, stem cell transplantation is relatively safe. Around one thousand stem cell transplantations were conducted at the CMC, Vellore. All of them were successful. Definitely, it is not as risky as organ donation.”
How are stem cells collected?
Stem cells are found all over our body and depending on the source of the stem cells, the collection procedure varies:
Umbilical Cord: This is the richest source of stem cells. Collection of stem cells from the umbilical cord is a safe, painless procedure. Pregnant women can choose to bank their child’s umbilical cord stem cells either for private use or to be donated to a public bank. 10 minutes after the baby’s birth, the umbilical cord is clamped and the blood from the cord is collected in a blood bag. This bag is sent to the laboratory where the stem cells are separated and preserved.
Side effects: The procedure does not affect the birthing process and is not harmful to the mother and the baby.
Adult Stem Cells:
Stem cell registries maintain records of the HLA typing of donors. When a donor registers with a stem cell registry a sample of the donor’s cheek swab is tested at the lab to determine HLA typing. The record of this is maintained on the registry. When a stem cell requirement is sought, the donor is requested to make a donation of his stem cells.
Peripheral Blood: In this method, the donor is given a special medicine that increases the volume of white blood cells and stem cells in the peripheral blood. Through a process known as apheresis, two intravenous needles are inserted and the peripheral stem cells are collected are collected through a machine. The machine returns the unneeded cells back to the donor. The procedure may be repeated depending on the volume of stem cells required.
Side effects: The medicine given may cause headache or muscle aches that may last for a week.
Bone Marrow: To donate stem cells from the bone marrow, the donor must match certain health parameters. The procedure involves giving the donor general anaesthesia. Bone marrow stem cells are removed from the back of the pelvic bone with a needle. This is a day surgery in which the donor can return home within a day.
Side effects: The site of the stem cell retrieval may become sore or bruised. Pain killers are prescribed to help alleviate the pain
While stem cell donation may take years to be understood and supported by common people, it is important that doctors keep expectant parents informed about the choices they have with respect to preservation/donation of their child’s umbilical cord stem cells.