SA Bone Marrow Registry is cautioning against outsourcing stem cell donation

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ToBeConfirmed

Published Aug 2, 2023

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According to the SABMR, this practice could potentially result in the loss of local expertise, which is crucial in the field of hematopoietic progenitor cell (HPC) transplants, commonly known as stem cell transplants.

These transplants serve as life-saving treatments for numerous South African patients suffering from various haematological malignancies, including leukaemia, lymphoma, myeloma, bone marrow failure syndromes, and genetic abnormalities.

According to Jane Ward, Deputy Director of the SABMR, searching for donors within the country is very important. She highlights several reasons why this approach is vital:

Retention and safe custody of the South African patient/ donor database:

Keeping the donor search process within the country ensures that the South African patient/donor database remains secure and accessible.

Increased chances of finding suitable matches:

Searching for potential donors within the same country enhances the likelihood of quickly finding a suitable match. It eliminates the time and logistical challenges associated with international searches, such as transportation and coordination.

Genetic diversity and compatibility:

Genetic diversity exists among different populations, and searching for a match within the same country increases the chances of compatibility between the donor and recipient.

This is particularly crucial for matching specific tissue types and human leukocyte antigens (HLA), which significantly impact transplant success rates.

Another non-profit organisation, DKMS Africa, an entity of the global international dedicated movement to eradicating blood cancer, draws attention to the fact that patients and donors of African descent have unique tissue characteristics.

Additionally, people of colour are severely under-represented in the global database and diversifying the donor pool is critical to helping more black, coloured, Indian and Asian patients with blood cancers in South Africa.

“Focusing on donors within the country allows bone marrow registries to prioritise individuals who are readily accessible for further testing and potential donation. This streamlined approach increases the chances of finding a willing and available donor.

‘’However, it's important to note that if a suitable match cannot be found within the country, registries may expand their search internationally to improve the likelihood of finding a compatible donor.

“While the donor pool in South Africa is growing, it is still insufficient to meet the needs of the population. To increase the chances of South African patients finding a local unrelated donor match, thousands more donors are needed,” explains Ward.

By emphasising the significance of local expertise and conducting donor searches within the country, the SABMR aims to ensure the retention of essential skills and enhance transplant success rates in South Africa.

It is a proactive step towards providing the best possible care for patients in need of life-saving stem cell transplants.

SA-based search coordinators also understand the language, geography, customs, and traditions of the country, which provide a much better patient service experience.

Local search coordinators also have a firm grasp on the specific genes that are predominant among SA’s 60+ million population.

These include at least 14 distinct ethnic groups and an estimated 870 distinct haplotypes, which is likely to increase as more research is done into South African population genetics.

She adds that haplotypes are important in the process of matching bone marrow or stem cell donors with recipients, as they provide information about genetic diversity within populations.

Donor search coordinators aim to find donors who have similar haplotypes to the patient, particularly within their ethnic or racial group. Similar haplotypes increase the chances of finding a suitable match.

Haplotypes consist of genetic markers or variations inherited together from a single parent and are used to distinguish one individual's genetic profile from another.

By comparing the haplotypes of a patient and potential donors, coordinators can determine the compatibility and likelihood of a successful transplant.

“Given that African populations are characterised by greater levels of genetic diversity compared to non-African populations, and the fact that they also possess several genetic adaptations that have evolved in response to diverse climates and diets, as well as exposure to pathogens and infectious disease, make it critical for South Africa to preserve its expertise in this field.

The SABMR is the only World Marrow Donor Association (WMDA) accredited registry in Africa and has been in operation for more than 30 years.

“When patients and/or transplant centres choose the SABMR as their registry of choice, they help to keep the expertise within South Africa, which not only benefits patients but creates a more skilled and diverse workforce that promotes the economic development and social well-being of our country,” asserts Ward.

If you would like to become a donor, please contact the SABMR on 021 447 8638 or email: [email protected]. Financial donations can also be made via www.sabmr.co.za/donate.

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