As soon as a patient is referred to the SABMR by his or her physician, the SABMR begins a preliminary search of donors on its local database
as well as the international database of Bone Marrow Donors Worldwide (BMDW), which stores the information of > 32 million donors
worldwide. This search is done, courtesy of the SABMR, at no cost to the patient. At this stage, the match is on paper only.
The SABMR presents the preliminary search results to the referring physician. These early results require further follow-up to find out which, if any, of the potential donors are suitable and available to donate stem cells.
The formal search involves contacting the potential donors identified and conducting further testing to establish whether they are indeed suitable matches for this patient. At this point, it’s important to establish the general health of the donor, their availability to donate and their willingness to proceed with the donation process. At this stage, the relevant fee is charged to the patient.
Short-listed donors are required to undergo a series of advanced laboratory testing to further establish heir suitability. Tests typically include high resolution typing at various loci (matching points).
Once a donor’s HLA typing shows there is a match with the patient, the next step is mandatory: in other words, the donor’s typing must be verified in the same laboratory that performed the HLA typing of the patient.
The matched donor will undergo a full medical examination to determine their health status and assess whether they are at any risk during the donation process. Once medically cleared to proceed, the donor will receive a five-day course of daily injections to increase the number of stem cells in their blood stream. On the fifth day of the injections, the donor will be admitted to a medical facility and be connected to a cell separator machine. The machine takes blood from the donor, removes the cells needed for the transplant, and returns the remaining cells to the donor’s body. Sometimes it is necessary for the stem cell collection to be done on the sixth day as well. A Donor Visitor, appointed by the SABMR, will accompany the donor throughout the day of the donation to support them in any way needed. Prior to the stem cell donation, the patient too will undergo a conditioning regimen of chemotherapy with or without radiation in preparation of the transplant.
Once the cells are donated, they must be infused into the patient within 72 hours of the start of the collection. The cells are transported in a specialised, temperature controlled hamper by a trained human courier and delivered directly to the transplant centre.
On the scheduled date of the transplant, the patient will receive the donor’s healthy stem cells. The transplant is not a surgical procedure but rather like receiving a blood transfusion. The cells are given to the patient through an intravenous (IV) catheter or tube. From there, the cells find their way to the patient’s bone marrow where they grow and start making healthy red blood cells, white blood cells and platelets.
The next step is the long journey to recovery. SABMR policy is to ask all patients to keep information about the transplant confidential for three months. This means that a patient, or his/her family and friends, should not give information about the timing or location of the transplant to newspapers, television stations, or any other media, including social media like Facebook or Twitter. The reason for confidentiality is that the SABMR does not want any assumption to be made about who the donor is. This would break the donor’s right to anonymity. Likewise the SABMR donors are requested not to provide any information publicly. However, should patients wish to write a “Thank You” letter to their donor, this is permitted and the correspondence will be coordinated by the relevant registries.
