Anyone can be a bone marrow donor, but when it comes to finding a match, race can be everything. There are certain genetic markers that doctors will look for when searching for a match — and if a match is made, a transplant can then be scheduled. If someone is in need of a transplant, the process can be daunting, especially if there is only a small pool of donors that share a similar ethnicity.
There are many bone marrow donor services throughout the country, but the Asian American Donor Program (AADP) is a champion nonprofit “dedicated to increasing the availability of potential stem cells donors for patients with life threatening diseases curable by a stem cell transplant.” Based in Alameda, CA, AADP holds donor registration drives and outreach events to Asian, Pacific Islander, and mixed race communities in the Bay Area.
Stem cells are found inside bone marrow, and those cells can turn into red blood cells, white blood cells and platelets. AADP explains that “red blood cells carry oxygen throughout the body; white blood cells help fight infections; and platelets help control bleeding.” Diseases like leukemia, sickle cell anemia, blood cancers, and many other immune diseases can be treated with a bone marrow or stem cell transplant. This “soft tissue” is incredibly important to our health.
To learn more about why bone marrow donation is important, and why it is particularly important in Asian Pacific American and mixed race communities, I reached out to Ruby Law, AADP’s Recruitment Director.
Hyphen: When does one need a bone marrow donation, and what does it do?
Ruby Law: Disease can affect the marrow’s ability to function. When this happens, a bone marrow or cord blood transplant could be the best treatment option. For some diseases, transplant offers the only potential cure. A bone marrow or cord blood transplant replaces unhealthy blood-forming cells with healthy ones. Blood-forming cells are also called blood stem cells. Blood stem cells are immature cells that can grow into red blood cells, white blood cells and platelets. Every year, 12,000 patients with blood diseases such as leukemia and lymphoma, sickle cell and other life-threatening diseases need a bone marrow or umbilical cord blood transplant.
Hyphen: Why is bone marrow donation important for Asian Pacific American and mixed-Asian Pacific American communities to address in discussions about health?
RL: A patient needs a matching donor for a successful transplant. The closer the match, the better for the patient. Patients are more likely to match someone from their own race or ethnicity. For example a Chinese patient will most likely need a Chinese donor, while a Japanese patient will most likely need a Japanese donor. Out of 10 million registrants in the United States, only 7% of the registrants are Asian and only 4% are of mixed race. Most Asian or Mixed Asian patients cannot find any matching donor in the registry because there are not enough Asian, mixed Asian and minority donors.
Hyphen: Why is signing up for the registry important? What kind of impact will signing up have on Asian Pacific American and mixed-Asian Pacific American communities?
RL: Only 30% of the time can a searching patient find a match from one of his or her siblings, the rest of the time a patient depends upon the generosity of a complete stranger. Some describe it as finding a needle in a haystack. Seven-year-old Baylor Fredrickson is of mixed Japanese and German descent. He’ll most likely need to find another Asian-Caucasian mixed race donor. His only sister is not a match, and sadly none of the registrants around the world is a match. AADP is helping the family to organize “A Match for Bay” campaign to encourage more mixed race and minority persons to register as marrow donors.
Hyphen: What happens once there is a match?
RL: A donor will be notified to provide a blood sample for confirmatory testing if he or she is a potential match. If the blood test determines a donor is a perfect match, they will perform another physical examination. The donor will donate their bone marrow or blood stem cells if he or she is the perfect candidate.
There are two methods of donation: Peripheral Blood Stem Cells (PBSC) and bone marrow. The patient’s doctor will choose which one is best for the patient.
PBSC donation is a non-surgical procedure. For five days leading up to donation, you will be given injections of filgrastim. Filgrastim is a medication that increases the number of blood-forming cells in your bloodstream. On the day of donation, blood is removed through a needle on one arm and passed through a machine that separates out the blood-forming cells. The remaining blood is returned to you through the other arm.
Bone marrow donation is a surgical procedure that takes place in a hospital operating room. Doctors use needles to withdraw liquid marrow from the back of your pelvic bone. Donors receive anesthesia and feel no pain during the donation.
The time it takes for a donor to recover varies. It depends on the person and type of donation. Most donors are able to return to work, school and other activities within one to seven days after donation. Be The Match Registry considers donor safety a top priority and will follow up with you regularly until you are able to resume normal activity.
Hyphen: Who can help, and how?
RL: We are looking for donors who are between 18 to 44 years old and in good health. People in this age group are selected as a donor by physicians over 90% of the time. Medical research has shown that cells from younger donors lead to better long-term survival for patients after transplant. Potential donors will fill out a form and provide a cheek swab sample. Please attend one of our community donor drives at www.aadp.org/drive or request a home test kit at www.aadp.org/homekit.
Ruby Law, Asian American Donor Program (AADP) Recruitment Director
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Andrea Kim Taylor lives and works in Washington, D.C. She is a museum educator and assistant editor for the Asian American Literary Review.