A bone marrow transplant, or stem cell transplant, is a life-changing cancer treatment. As explained by Be The Match, the transplant process starts out with chemotherapy and/or radiation therapy as a means to kill off the cancer cells which simultaneously kills the bone marrow cells as well. Following the cancer therapy comes the donor stem cells which will take the place of the previously-killed cells leaving space for the new ones . Next comes the “miserable period” in which the patient is physically, and subsequently mentally, feeling the effects of chemo/radiation, processes which take a toll on the body and mind in both pain, exhaustion, etc., a period in which support is vital. Post-transplant monitoring checks for engraftment to ensure a successful transplant in which the donor cells are growing in the patient’s blood observable by increases in red blood cell, white blood cell, and platelet counts back up to normal levels.
Matching for an allogeneic transplant is a tricky process in that the complexity is much more intense as a match is based on genetic markers called human leukocyte antigens (HLA), proteins found on most of your body’s cells. Due to matching with genetic markers, this affects your donor pool to people with more similar genetic make-ups as you corresponding to ethnic background. While the Be The Match registry has a wide selection of potential donors, the likelihood of a perfect match ranges based on your ethnicity due to the increased or lacking diversity of the donor pool. HLA matching is done via blood test to ensure 8-10 matching markers between patient and donor or alternatively 4-6 markers from cord blood units. As HLA markers are genetic, your immediate family, specifically your siblings, are a potential chance, ~25%, at a perfect match in an immediate manner as you would all have inherited similar HLA patterns from your parents. An imperfect match could decrease the success rate of treating the patient’s disease as well as complicating the recovery process as your body so this is a vital step in ensuring the best chance at engraftment and an overall successful treatment.
A bone marrow transplant is life-altering, physically and emotionally, not only for the patient but for the family. As someone who spent the past year as a part-time caregiver to my mom who received a bone marrow transplant for lymphoma treatment the attestation of the familial toll is first-hand. To watch a loved one suffer during the “miserable period”, which lives up to its name, is a terrifying and unforgettable experience as they fight to push through the treatment into the better parts of recovery. As a daughter, despite being a committed, healthy person between the ages of 18-40, my ability to donate was all but impossible due to the genetic composition of being 50% my mom and 50% my dad resulting in a feeling of helplessness. Luckily, as a white person, my mom had a significantly higher chance of finding a donor compared to a patient who was American Indian, APA, Hispanic, Latino, or especially black. My friend at UNC, also recently diagnosed with lymphoma was going through the process of finding a donor as well through the registry and had a much longer process due to his Hispanic ethnicity pointing out the stark differences patients face medically every day based on systemic issues. Whether you are signing up to be on the registry, learning more about cord blood donation during your pregnancy as an option for you to partake in, or any other supportive measure you take to support BMT patients, you are helping to save a life. I would give everything I have as a daughter to save my mom who gave me everything, but it is only with the help of donors that people like her can have this opportunity at life.
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