The Medical Director and CEO of the South African Bone Marrow Registry (SABMR), Dr Charlotte Ingram, explains how they are collaborating with bone marrow registries across the globe to give patients an increased chance of finding a donor match.
Ethnic diversity is one of the strongest defining characteristics of the South African nation. It makes our country unique but it also plays a powerful role in giving patients with life-threatening illnesses such as leukaemia or marrow failure the prospect of renewed health.
Often a blood stem cell transplant is the only chance of survival for those that suffer from blood cancers. Many different tissue types exist, which means that finding a suitable match is largely dependent on having a large registry of donors. This is why the SABMR, a not for profit organisation, collaborates with registries across the globe to give patients an increased chance of finding a donor match.
Finding a suitable match
The SABMR truly epitomises the meaning of the word “Ubuntu”: a uniquely African term that represents the belief in a universal bond of sharing that connects all humanity. When finding a donor, family members are looked to first; brothers and sisters are generally the most suitable matches. However, due to today’s smaller family sizes, only about 30% of patients match with a donor in their own family.
If a suitable donor within one’s family is not found, the SABMR will be approached by the Transplant Centre to find a potential donor within its “home” registry. The SABMR will also turn to the international database to see if there are any potential matches. Fortunately, it has access to an additional 30 million donors via the World Marrow Donor Association (WMDA) and the Bone Marrow Donors Worldwide (BMDW) service.
Collaborating across boarders
International collaboration has already allowed the SABMR to find matching donors for many patients both in South Africa and from many different countries. To date, it has facilitated stem cell transplants for over 400 patients in South Africa; 25% of patients received stem cells from local donors, whilst the remaining 75% received stem cells from international donors.
The connection that the SABMR has with its global partners, BMDW and WMDA, has proved so valuable that the SABMR has also has provided stem cells to 21 patients in 11 different countries worldwide.
Although the SABMR is small compared with registries in Germany and the USA, it currently ranks in the top three for the contribution of unique human leukocyte antigen (HLA) phenotypes to BMDW. HLA variability is particularly unique in South Africa, where diverse populations – including those of African ancestry – exist, resulting in uncommon phenotypes.
In recent years, we’ve had the privilege of witnessing South African patients such as Andrew Melck – who was diagnosed with leukaemia – find a 10/10 match on the German database, and Taahirah Msomi – who was diagnosed with Acute Myeloid Leukaemia – find a suitable match from the USA. These are just two examples of the wonderful impact that access to the international database can have.
Increasing the donor database
For South African patients, the SABMR helps by facilitating the matching, collection and transportation of stem cells between the donor centre, which might be local or international, and the transplant centre. It additionally facilitates donations from South African donors to patients locally and internationally.
At present, the odds of finding a match is 1 in 100,000 but if we had more registered donors, we would be able to help save more lives locally and around the world. As such, the SABMR’s goal together with The Sunflower Fund, is to grow the numbers of donors on the SABMR to ensure that the rich ethnic diversity of South Africa does not only benefit South African patients but those across the globe as well.