Stem Cell Donation

An allogeneic stem cell transplant needs a ‘donor’ to ‘donate’ his hematopoietic stem cells to the patient. Finding a fully matched sibling donor is becoming increasingly difficult due to decreasing family size – there is a 25% chance of one’s sibling to be a fully compatible HLA match. It is understood that 70% of patients who require a HSCT wouldn’t be able to find a matched donor in the family. Every year 40,000 patients die because of not finding a voluntary stem cell donor in India. This creates a huge demand-supply gap and a very big hurdle in use of HSCT as a treatment option.

Is there a solution for patients without a donor in the family?

Yes. This is through voluntary stem cell donation. This is co-ordinated through various NGOs, public registries, which maintain the donor details. Some of the registries which do such activities are DATRI, MDR-I (Marrow donor registry-India) etc. DATRI is the largest such registry in India with 4 lakh+ registered donors.

Who can register?

Any healthy person between 18-55 years of age can register as a donor. This registration can happen through ‘donor registration camps’ conducted by the registries. Alternatively, a willing donor can reach out to the registry and send his sample across after giving the needed consent.

How safe is ‘registering’ as a donor?

It is very safe and easy. A buccal swab (from inside of cheeks) is collected from the donor, a consent is taken and the sample is shipped to the central lab. This sample gets processed at the lab and the donor HLA is identified and recorded in the registry. This data is looked up while trying to identify a match for a patient requiring HSCT.

What happens when a donor is identified for a patient?

The donor gets notified and a confirmatory sample is sent to cross check the results. After this, a health check is done for the donor to establish a normal health status of the donor and to rule out any transmissible infections. The donor gets referred to a nearest collection centre where a physician checks him/her and reports. G-CSF injections which mobilize stem cells from bone marrow to peripheral blood would be given for 4-5 days. Donor might experience mild body aches with this. Stem cell collection is done on 5th day. This is like donation of blood or platelets though it takes a longer time (approx. 4 hours). The donor might experience some tingling sensation around lips or on finger tips which goes away with a dose of calcium. The donor can resume normal activities after a brief rest of around 4-5 hours.

Figure 1: Schema of stem cell donation to transplant process

The domain of stem cell registry in India is nascent at best – the probability of finding a match through this registry is a dismal 0.0008 percent! Indian donors find very scarce representation in international registries. This gap can only be bridged by having robust, native stem cell registry with HLA data covering at least 1% of population.

To this end, we have conducted a ‘voluntary stem cell donation awareness drive’ in association with DATRI in the month of November, 2019. The target was to sensitize the general population, and with a specific focus on students and young Indians, regarding its importance and to also register new donors on a mass scale. The program was a huge success in terms of footfall and managed to register 300 prospective donors (Figure 2).

Collection of buccal swab from voluntary participant

A public awareness programme by MGCH&RI

Voluntary stem cell donation awareness drive (Nov 2019)

Inauguration of Donor collection centre of DATRI at our BMT unit

Figure 2: Stem cell donation awareness drive by MGCHRI & DATRI