Coronavirus pandemic poses a challenge to blood stem-cell transplants, donor registration drives

About 30 percent of patients find a sibling match as stem cell donors and the rest 70 percent depend on finding a matching unrelated donor.

Amidst the coronavirus outbreak across the world and when COVID-19 dominates every industry present, we must keep in mind the impact it is having on medical care especially in the treatment of conditions like blood cancer, thalassaemia and other blood-related disorders.

COVID-19 has seriously impacted the delivery of blood stem cells required for a transplant along with potential donor registration drives. The disease also poses a health risk for blood cancer patients as they are immune deficient, and they are more prone to infection than any of us.

Immunodeficiency is the inability to produce an adequate immune response because of insufficiency or absence of antibodies or immune cells, or both.

Blood stem cell transplant stands as a ray of hope for people suffering from blood disorders. Once an individual comes up as a match for a blood cancer patient, his/her blood stem cells are obtained from the bloodstream using a procedure called peripheral blood stem cell collection, which is similar to a blood platelet donation wherein only the blood stem cells are taken. The collection of blood stem cell is not restricted to a state or country and travels across borders to patients in other countries as well.

Coronavirus is making it hard to transport the blood stem cells to the patients in need.

Coronavirus is making it hard to transport the blood stem cells to the patients in need.

Currently, the biggest challenge lies in answering the following question: How do you get the transplants from point A to point B? More specifically, from the collection centres to the transplant centres where the patients are treated. The uncertainty that patients will not receive their transplant on time due to the constantly changing situation must be minimized as much as possible in the current COVID-19 crisis.

The aim of transporting blood stem cells to the patient is to deliver the blood stem cells as quickly as possible by couriers (using special transport) to the specialist centre. The patient is conditioned at the same time as the donor's stem cells are collected. If the conditioning — i.e. the pre-treatment — of a patient for stem cell transplantation has begun with high-dose chemotherapy and radiation, it is essential that the transplant takes place promptly. Due to the travel restrictions imposed by many countries, this has come to a halt.

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However, clinicians can speak to transplant centres about the possibility of cryopreservation, i.e. the freezing of transplants at minus 180 degrees Celsius, either in the transplantation centre or at the collection centre which has the license for cryopreservation. In this case, the transplantation of the patient could - after consultation - be performed with a time delay.

In such times, it is also important to consider the health and safety of the donors who are asked to donate their blood stem cells. Proper screening guidelines for COVID-19 should be set before entry into collection centres and before the start of the donation. These measures serve to protect the donor as well as the recipient and the employees in the collection centres.

Every five minutes someone in India is being diagnosed with blood cancer. Only about 30 percent of the patients in need of a blood stem cell transplant as life-saving treatment, can find a sibling match. The rest 70 percent depend on finding a matching unrelated donor. Since ethnicity plays a role in a successful blood stem cell transplant, it is important for each of us to register as a blood stem cell donor.

Unfortunately, the COVID-19 outbreak has prompted people to stay indoors. As a result, blood stem cell donor registration drives have stopped in the country. This gap can be minimized by encouraging people to register online as potential donors and give patients suffering from Blood Cancer or other blood disorders like Thalassemia a second chance at life.

The author is the CEO of the NGO DKMSxBMST Foundation, India

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