Have you ever heard of the organisation Marrow? What about York Marrow? Well, I had the pleasure of talking to Hannah, the president of the York Marrow Society who told me all about the amazing work they do and most importantly how it all works.
Marrow is the “student branch of the national charity Anthony Nolan”, which recruits people to the stem cell register. That is, they get people to sign up for a list which says that, if contacted, you would be willing to discuss the idea of donating your stem cells to somebody in need. There is only a 1 in 100 chance that you’ll actually get called up.
It is important to note that if you are on the register you are not obliged to then donate, there is always the option to say no. Equally, many people sign up and never get called. As Hannah was telling me, ultimately “we need as many people as possible to sign up so there’s a greater chance that you can find a match”.
Before we get ahead of ourselves, it’s important to establish the basic facts here… I’m not ashamed to say I had to clarify with Hannah (a Biology graduate) what a stem cell is! Stem cells are a special type of cell found within bone marrow that can turn into different types of blood cells. Specifically, these cells are called hematopoietic cells: importantly, they have the ability to turn into both white and red blood cells and platelets.
Over 2,400 people in the UK are in need of a bone marrow or stem cell transplant every year and yet only 2% of people in the UK are registered as stem cell donors.
The main reason somebody may find themselves needing a stem cell transplant is due to blood cancer. Unlike some other cancers, where treatment would consist of removing a tumour, with blood cancer the cancer cells are in the blood and therefore being pumped all around your body; it is almost impossible to target a certain area. Doctors for patients with blood cancer often go down the route of stem cell transplants.
They would suppress the patient’s immune system to such a low level that somebody else’s stem cells can be inserted and hopefully accepted by the patient’s body. Unfortunately, this process is not as simple as somebody just donating cells. Similar to organ transplants, the stem cells of the donor and those of the patient need to match. “It’s more than just a blood type, you have many factors,” Hannah told me. Often individuals all have different viruses on their cells, called CMV, and therefore everyone’s cell makeup is different. This is similar to fingerprints, no two are the same. Sometimes a patient can find a match from a family member; however, this isn’t always the case and that’s where the stem cell register comes in.
“Imagine if it was your relative”
Signing up to the register is very easy. “It’s just a cheek swab.” This swab is sent off to the Anthony Nolan labs to get an initial picture of your DNA and then that’s it! You’re on the register! Very simple really. For the charity, there is a cost of £40 for every individual who signs up and this is why fundraising, through branches such as York Marrow, is so important. Anthony Nolan will only fund for people under the age of 30 to sign up but once you’ve signed up you are on the register until the age of 60. You can sign up to join the register through the Anthony Nolan and Marrow websites, where you will be sent a swab to your home address. Or, you can contact the York Marrow Society and attend one of their events where someone will be able to tell you more and help you complete the swab.
So, what actually happens if you’re contacted? Anthony Nolan will contact you via email or phone if you are needed for a stem cell donation. The first step will be to have a series of blood tests to ensure you have a clean bill of health. This is because there can be no risk that the donor is passing on any sort of disease to the patient, especially because during the period of donation the patient’s immune system is suppressed and therefore they are even more likely to catch a virus. After this, around 4 days before the donation, a nurse will come to your house and give you some injections. These injections are to cause your body to produce lots of extra stem cells. Many donors say this is the worst part of the process as it leaves you feeling achy. After all, your body is being forced to produce loads more cells.
After this, you will get a date to go to one of the Anthony Nolan clinics. They have these all over the country and the charity funds your transport and entire visit. This includes food, travel, hotels and even any covers any time off work that you are missing. As Hannah kept telling me, “It is quite easy”.
Callum-Kennedy Mann (pictured below) is a University of York graduate in History and Politics who went through the stem cell donation process.
“They get blood out of one arm, filter the stem cells out and put the blood right back in your other arm”
The actual process normally takes around 3 hours although some donors are required to come back the next day for a second round. Effectively, you are wired up and they take blood from one arm, filter out all the stem cells, and put the blood straight back into your other arm. This is a process called peripheral blood stem cell collection. 90% of the time this is how you will donate, although in rare cases they may ask if they can take some bone marrow from you. As with the entirety of the process, you will always have the option to say no. After this, the process is done! In most cases, there are no real side effects and you should be able to return to your normal life within a day.
For the first 2 years, the patient remains anonymous. This is mostly for legal reasons. After this, the patient has the choice to contact their donor if they’d like to.
The process is a lot less invasive than I thought it would be. At the moment Marrow are really trying to increase the diversity of the register.
Only 72% of patients from a white Caucasian background can find the best possible match from a stranger and this drops to 37% for patients from a minority ethnic background.