Blood Stem Cell and Bone Marrow Donations For Allogeneic Transplants
Position Statement
Background
When stem cells in someone’s bone marrow get damaged or destroyed because of blood cancer, a life-saving stem cell transplant from a health donor is often necessary to rebuild the body’s blood and immune systems.
Stem cells are the building blocks of all blood-forming cells that normally live in the bone marrow. These stem cells can be likened to ‘super’ cells that have the ability to form all other cells. They divide and mature into all the different types of blood cells (red cells, white cells and platelets), including the cells of our immune system and are therefore vital for our survival.
There are two forms of stem cell transplants: autologous transplants and allogeneic transplants. Autologous transplants use a patient’s own cells, whereas an allogenic transplant uses stem cells from a matched donor.
Autologous transplants by their inherent nature are non-controversial.
This position statement relates primarily to allogeneic (donor) transplants.
Our position
Every year, more than 600 Australians with blood cancer will need donated stem cells for a potentially life-saving allogeneic transplant.
Some patients find a matched donor in their family, but more than half will need stem cells from a matched but unrelated individual. At this point things can get more complicated.
In Australia, the matching of stem cells between recipients and donors is organised by the Australian Bone Marrow Donor Registry (ABMDR).
However, not enough suitable Australians are registered as a donor and so the ABMDR is currently unable to meet demand without searching overseas.
Currently, about three in four of all stem cell donations are sourced from overseas donors.
This can cause complications as donor cells need to travel far distances to reach patients who need to receive the new stem cells quickly. Delays associated with travel can impact the viability of the donor cells, which can result in further complications. Overseas donations also cost significantly more than having local Australian donors.
Relying on overseas donations also means patients from ethnicities not well represented on international registries, like First Nations peoples, may be more difficult to find a suitable matched donor.
The COVID-19 pandemic also highlighted more risk to patients, with reduced access to overseas donors and increased risk of transport delays and damage.
The Leukaemia Foundation wants to see Australia’s reliance on overseas donors decrease with having more suitable Australians on the Australian Bone Marrow Donor Registry (ABMDR). The Foundation is calling on all Australians, and especially those from diverse ethnic backgrounds, to become stem cell donors and join the Australian Bone Marrow Donor Registry.
Becoming a blood stem cell donor by registering with the ABMDR or with Red Cross Lifeblood means you could potentially save the life of someone with blood cancer.
In Australia, there are two organisations who take on the important work of managing and enrolling people to become stem cell donors.
The Australian Red Cross Lifeblood has the responsibility to sign donors up to the Donor Registry.
The management of the Donor Registry is run by the Australian Bone Marrow Donor Registry (ABMDR). The ABMDR also runs Strength to Give, a cheek swab-based enrolment program.
The Leukaemia Foundation fully supports the work of Australian Red Cross Lifeblood and the ABMDR, and we also welcome other cheek swab-based enrolment programs, such as Strength to Give, to grow and diversify Australia’s donor pool.
The National Strategic Action Plan for Blood Cancer (National Action Plan) outlines recommendations to support the enrolment of underrepresented populations on the Australian Bone Marrow Donor Registry. You can read the National Action Plan here.
Who should join the registry?
The Leukaemia Foundation encourages all eligible Australians to join the Registry. In particular we urgently need younger donors (18 – 35-year-olds) to register, as stem cell donations from younger donors can result in better outcomes for patients. Ethnic diversity is also important as patients are more likely to find a match with a donor from the same ethnic background. Young men also make particularly important donors – as men on average are physically larger than women, they literally have more to give.
How to join the registry
If you can give blood, you can volunteer to become a stem cell donor through the Australian Red Cross Lifeblood. Importantly, some of the restrictions that apply to blood donation do not apply to stem cell donation.
Next time you are giving blood, ask a Lifeblood staff member about becoming a stem cell donor. Alternatively, if you can’t give blood, you may still be able to register – you’ll need to contact Lifeblood on 13 14 95.