Monday, August 18, 2008

Blog by Dr. Sripriya Santhanam

Blog by
Dr. Sripriya Santhanam,MD
Hematology/Oncology
Shivers Cancer Center
Brackenridge Hospital
E-mail:ssanthanam@seton.org

Acute myelogenous leukemia (AML) is a fast-growing cancer of the blood and bone marrow.May patients are treated with chemotherapy.Bone marrow and stem cell transplants are a way of allowing much higher doses of chemotherapy to be given, to improve the chances of completely curing the leukemia.A person has only a 25 percent chance of finding a match within their own family,hence the desperate need to find an unrelated donor to save their life .

South Asians,especially Indians are woefully underrepresented in the national bone marrow registry.We make up only .1% of the 7 million names listed in the National Bone Marrow Donor registry – which means that matches for Indian are slimmer and the wait is longer.A Caucasian seeking a match in the registry averages 15 hits; a South Asian 1 or 0. Manish's chances of finding a match are less than 1 in 200,000. Often, the person does not survive while a search for a match is still going on. Chances of survival without Bone marrow transplant are less than 50 % only. Hence, if all members of Indian Community between the age of 18 through 60 years, men and women alike, have their name on the National Bone marrow Registry, it would help save hundreds of lives.

HLA stands for human leukocyte antigens, and humans have many of them. But transplant doctors usually look at six - three inherited from the father and three from their mother.The actual process is much more complicated, but for a bone marrow transplant, the donor and recipient must match on at least five of these six antigens and also have a compatible blood type. The odds of two individuals matching range from 1 in 20,000 to 1 in 50,000. The genetic component is what makes people from the same racial group more likely to match.You - through a simple cheek swab - could be that miracle match for Manish. Or for one of many other individuals waiting for a bone marrow match.(For those of you who are scared, this is NOT a blood test. No needles are involved that day!) If your bone marrow appears to be a suitable match for someone waiting for a transplant, you'll undergo a brief examination to ensure that your bone marrow can be transplanted. The doctor will want to rule out any genetic or infectious diseases you might have, since these can be passed on to the bone marrow recipient.

Peripheral blood stem cell (PBSC) donation is a way to collect blood-forming cells for transplantation. The same blood-forming cells (sometimes called blood stem cells) that can be donated from the bone marrow are also found in the circulating (peripheral) blood. Before donation, a donor takes injections of a drug called filgrastim to move more blood-forming cells out of the marrow and into the bloodstream. Then the donor's blood is removed through a needle in one arm and passed through a machine that separates out the blood-forming cells. The remaining blood is returned to the donor through the other arm. This process is similar to donating plasma.

Myths and facts about marrow donation:
http://www.marrow.org/HELP/Join_the_Donor_Registry/Myths_&_Facts_about_Marrow_Don/index.html

NMDP Registry Breakdown By Race Categories
Caucasian 75%
African American 8%
Asian / Pacific Islander 6%
Hispanic 8%
Native American 1%
Multi-Racial 2%

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