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myths around stem cell donation are costing lives
donating doesn't hurt any more than the prick of a needle — and for that you could save someone's life.
mar 10 2021
8 minute read
getty
last month, healthing posted a story about laura laycock collard who is living with chronic myeloid leukemia (cml) and is in desperate need of a stem cell transplant. laycock collard is part lebanese, which matches the description of less than two per cent of canadians in the registry.
her story not only raised awareness of the devastating consequences of lack of diversity in donors, but also highlighted the misinformation and confusion that surrounds the process and eligibility when it comes to life-saving stem cell, blood and plasma donation.
here are some of the facts you should know. most importantly, donating doesn’t hurt any more than the prick of a needle — and for that you could save someone’s life.
donating stem cells
myth: if you’re not eligible to donate blood, you’re not eligible to donate stem cells
this is not true. while the health screening questionnaire is similar for both blood and stem cell donation, people who are ineligible to donate blood may still be able to donate stem cells. the best way to find out is to visit the canadian blood services website and fill out the stem cell questionnaire. if you are eligible, a swab kit will be mailed directly to you.
myth: men who have sex with men are ineligible to donate stem cells
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there are no restrictions or barriers for men who have sex with men to donate stem cells. while the health and screening test will still ask this question, it’s simply to provide detailed information to the transplant centre.
myth: stem cell donation is painful
this is a common misconception. dr. heidi elmoazzen, director of stem cells at canadian blood services, says the majority — upwards of 90 per cent — of stem cell donations are done through peripheral blood stem cell collection, which is via a needle and very similar to donating blood. in the days leading up to donation a donor is given a drug injection to stimulate the production of stem cells from the bone marrow into the blood stream. the actual donation process takes four to six hours.
a small percentage of donations are done via surgery under anesthesia, where liquid marrow is withdrawn with a needle from the back of the pelvic bone. this procedure can last up to 90 minutes and can cause soreness for a couple of days. whether a donation is done peripherally (in a clinic), or surgically, is determined by the recipient’s doctor, not by canadian blood services.
myth: you can choose who your stem cells go to
when you join the stem cell registry, you are agreeing to donate to anyone in the world. unfortunately, up to 50 per cent of canadians who join the registry back out when they’re contacted as a match. “if you’re not sure about it, just don’t do it,” says mai duong, cofounder of swab the world . “signing up for the registry shouldn’t be a peer pressure game, because at the end of the day, it’s going to be the patient who will suffer if you back out.”
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many times a person only has one match, which means backing out could cost someone their life.
myth: the stem cell matching process is simple
the matching process is a complex science, where human leukocyte antigens — a protein found on the surface of white blood cells — are used to match patients to donors. the match has to be nearly perfect; otherwise, the recipient is at risk of complications such as graft-versus-host disease, where the donor’s immune cells attack the recipient’s own tissue. this highlights the need for diversity in the registry. the best chance of matching is with someone of the same ancestral background, but canada’s registry is 66 per cent caucasian and less than four per cent mixed race.
“your community is your own safety net — if there are no asians in the stem cell registry, we can’t save asians, it’s as simple as that,” says duong.
myth: once you turn 35, you’re no longer eligible to donate stem cells
individuals in canada must be between the ages of 17 and 35 to join the registry. the reason for this is twofold. first, research suggests the age of a stem cell donor is one of the most important characteristics influencing patient survival following a stem cell transplant, and younger donors are associated with better survival rates for patients.
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secondly, cbs says because there is limited funding allocated to running the stem cell program, this age restriction is in place to optimize the registry.
however, someone who joins by their 35th birthday will remain on the registry until they turn 60, which means you can still donate stem cells until your 60th birthday.
myth: every country has the same stem cell donation eligibility criteria
each country has its own guidelines and eligibility criteria when it comes to stem cell donation. however, no matter what registry you join, you will be searchable by any transplant team in the world. you can visit swab the world and click on the country you reside in for details on eligibility criteria.
fact: males are preferred for stem cell donation
large scale studies suggest using male donors reduces the chance of graft-versus-host disease. cbs says in its experience, transplant physicians select male donors around 75 per cent of the time because they’re on average physically larger, which means they’re able to donate more stem cells in one sitting.
fact: the transplant team will work with you to coordinate stem cell donation
there are select sites across canada where stem cells can be donated. if you match with someone and don’t live in one of these cities, canadian blood services pays for travel expenses including childcare, car rentals and hotel stays. elmoazzen says the cbs team works closely with donors to work out logistics to make sure the donation process is as smooth as possible.
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donating blood
myth: there is an age limit on donating blood
there is no upper age limit for donating blood, although you cannot donate blood for the first time if you are over 67 years old.
myth: men who have sex with men are ineligible to donate blood
men who have sex with men are eligible to donate blood three months after their last sexual contact with a male partner. the goal of cbs, according to delphine denis, media relations manager, is to implement behaviour-based screening for all donors, rather than a waiting period for men who have sex with men and are supporting several research projects investigating various aspects of blood and plasma donor eligibility criteria, including this one.
myth: having diverse blood donors isn’t important
most people who need a blood transfusion can be simply matched to their abo blood type. however, some people have rare blood types that require specific matches; otherwise, their body may attack and destroy the transfused blood cells. someone with a rare blood type is much more likely to find a donor with a similar ancestral background, which means having a diverse blood bank is important.
fact: blood is rigorously tested for disease after donation
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blood is tested for many infectious diseases including hiv, hepatitis b and c, human t-cell lymphotropic virus, syphilis and sometimes west nile virus and chagas’ disease.
this begs the question of why some exclusionary criteria exist despite thorough testing. cbs uses hiv as an example to explain this. while the technology used to test blood is sophisticated, there is a brief period shortly after infection when hiv is not detectable, which means testing wouldn’t detect the virus, and the donation could infect a patient. this is also why testing is combined with an in-depth health questionnaire.
plasma donation
plasma is a protein rich liquid that helps other components of blood circulate throughout the body and supports the immune system. plasma can be used to help patients with immune deficiencies, rare blood disorders, certain types of cancers, bleeding disorders, severe burns and more.
what is the difference between plasma used for transfusion and source plasma?
plasma is used for two different purposes. the first is for transfusion in hospital, similar to a blood transfusion. the second is called source plasma, which is plasma that is treated and turned into plasma protein products. these are pharmaceutical drugs, the most common being intravenous immunoglobulin which is used to treat many conditions including immune deficiency.
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how does the donation process work?
when you donate blood, plasma is separated out from your whole blood donation. however, this isn’t meeting the need of canadians who require plasma transfusions or plasma protein products. there are seven sites across the country, housed within whole blood donation clinics, where you are hooked up to a machine to donate plasma only. the machine collects blood, separates out the plasma, and returns the rest of your blood to your body. the actual donation process takes around 30 minutes.
last year, cbs launched two dedicated plasma collection centres in lethbridge, alta. and sudbury, ont., and plan to open a third in kelowna this june.
what happens to donated plasma?
all plasma is tested for infectious disease. then, some is frozen and sent to hospital for use when someone needs a transfusion. but hospitals are relying more and more on plasma protein products rather than transfusions.
cbs ships plasma to the u.s.a. and europe where fractionation companies use technology to break down plasma into specific therapeutic proteins. several plasma donations are pooled together and treated with chemicals to create plasma protein products, which are then sent back to canada to treat patients.
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covid-19 and plasma
last year, cbs teamed up with physicians across canada running clinical trials on the use of convalescent plasma — plasma collected from people recovered from covid-19 — to see if the antibodies could be used to treat patients with the virus. the trials are now closed, and data is being analyzed.
how you can help
visit swab the world for information on stem cell donation in every country (including canada). you can join the canadian stem cell registry by visiting the canadian blood services website . canadians can book an appointment to donate blood by visiting the canadian blood services website or by calling 1-888-236-6283. information on plasma donation can be found on the cbs website , including where to donate . canadians can also register online to be an organ donor and visit the cbs website to find other ways of getting involved.
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