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Jerlene Xie was at a company event in October 2016 when she came across a booth by the Bone Marrow Donor Programme (BMDP). There, she learnt what bone marrow donation was and how it could save someone’s life.
The sales and marketing manager, then 31, decided to add her name to the registry.
“Since young, I’ve found it amazing and meaningful how someone could just donate their bone marrow and save a life. And I thought to myself that if this could help someone, then why not? I have nothing to lose,” said Xie.
Six Singaporeans are diagnosed with a blood-related disease every day, according to the BMDP website, including leukaemia, lymphoma and myeloma.
For patients who don’t respond well to standard chemotherapy or radiotherapy, a bone marrow transplant is their last chance of survival.
The search for a suitable donor usually starts with the patient’s family members, although it’s not always a 100 per cent match. About 70 per cent of patients end up looking to a public registry to find a match.
The BMDP is the sole registry of volunteer marrow donors in Singapore. Besides facilitating marrow transplants locally, the BMDP is connected to a global network of more than 90 registries through the World Marrow Donor Association that facilitates marrow transplants from overseas donors to local patients, and vice versa.
When a local donor is a match for a patient overseas, the medical check-up and bone marrow collection is done in Singapore and the harvested stem cells couriered to the patient’s country.
Xie got the call five years after signing up with the BMDP. “Initially, I thought it was a scam until the staff provided me with all the documentation, and only then did it occur that I was a match for someone. I was surprised that it was for someone that I didn’t know,” she said.
In the two-month run-up to the donation procedure, Xie went through various medical tests, including blood tests, an electrocardiogram, a check for infectious diseases, and a physical examination.
She also met with a haematologist (a doctor specialising in blood disorders) from BMDP’s assigned collection centre. Due to the confidential nature of the donation, the doctor the donor meets is different from the doctor, and even the hospital, caring for the recipient.
There are currently 123,866 donors registered with the Bone Marrow Donor Programme (BMDP), as of June. Based on Singapore’s population size, the registry needs at least 350,000 donors to improve the probability of finding a local donor for a local patient.
Who can register: Singaporeans, permanent residents and long-stay foreigners aged 18 to 49 years old who are in good health. Individuals with coronary artery disease, thalassaemia major, stroke, Hepatitis B and HIV, are not eligible to donate.
How to become a donor: Register at the BMDP website. A swab kit and registration form will be mailed to you. Follow the instructions to complete the swab, fill up the form and mail the kit back to BMDP.
What happens after you register: It takes three to five months after submission to be added to the registry. During this period, eligibility checks are done and your swab is sent to the laboratory for tissue typing to determine your unique human leukocyte antigen (HLA) and blood group. HLA plays a crucial role in the body’s immune response and can vary from person to person.
When you may become a match: Once your name is in the registry, it will remain there until you age out at 60 years or become medically ineligible. Being matched to a patient may take a year, 10 years, or never at all.
Who you might be a match for: Likely someone of the same ethnic group as you. Donors are matched to patients based on HLA tissue type. You inherit HLA markers from your parents and through your ethnicity – so a patient’s best chance for a match is from a donor of the same ethnic background. However, the odds of local patients finding a local donor is less than half for every ethnic group – 40 per cent for Chinese, 20 per cent for Malays, and two per cent for Indians.
Currently, Malays make up eight per cent of donors in the registry, and Indians make up nine per cent, making it more challenging for Malay and Indian patients to find a match.
To find out more about the Bone Marrow Donor Programme, go to www.bmdp.org
Bone marrow donation does not involve extracting bone. It also causes no harm to the donor in the long-term.
Two methods are used for bone marrow donation: Peripheral blood stem cell (PBSC) collection and bone marrow collection. The former involves collecting stem cells from the blood while the latter takes liquid marrow from the back of the pelvic bone and is done under general anaesthesia.
Xie opted for PBSC collection. In the four days prior to the procedure, she had to inject herself daily, in the abdomen or thigh, to stimulate the production of blood stem cells. The final injection was done on the day itself.
“I did experience some pain, but the discomfort was bearable,” said Xie. Donors may experience some flu-like symptoms, slight bone aches or feel tired from the injections.
However, on the day of donation, which is done a day before the transplant, the medical team found that the veins on Xie’s arms were too thin to collect the blood stem cells from, so they went through the veins in her neck instead.
The collection process lasted five to seven hours, and was done through an apheresis machine, which draws blood from the donor, isolates the blood stem cells for donation before returning the remaining blood to the donor.
“I was even back to work the next day,” said the 39-year-old.
The infusion of healthy blood stem calls from a donor stimulates new bone marrow growth and restores the production of healthy blood cells in the patient.
The recipient of Xie’s blood stem cells was retired businessman Ting Chew Thai, whom she met for the first time at BMDP’s Bone Marrow Donor-Recipient Meet on Sep 21.
The then 73-year-old had been diagnosed with acute myeloid leukaemia (AML) in November 2021. AML is a type of blood cancer caused by an excessive production of a type of immature white blood cells, called myeloblasts, in the bone marrow.
Ting told CNA Women: “My condition was progressive and would be life-threatening without a bone marrow transplant. And though my age and the active status of my disease placed me at a higher risk of transplant failure… I knew that if I refused to try, I would definitely lose this battle.”
Within a month, Ting’s doctor, Dr Dawn Mya, a haematologist from Parkway Cancer Centre, found a few suitable donors and identified the most ideal donor – Xie.
A few days before the transplant, Ting checked himself into the hospital for conditioning chemotherapy, which involves getting a high dose of chemotherapy to prepare the body to receive the donor blood stem cells.
The bone marrow transplant took place a day after Xie’s blood stem cells were collected and processed, on Jan 28, 2022, and was completed within an hour. Ting then recovered in hospital for five to six weeks.
Due to the bone marrow transplant, Ting’s blood type has changed and is now the same as Xie’s.
“I am very thankful that my donor has given me a second chance to live,” said Ting.
Xie said she had no regrets becoming a bone marrow donor. “I am happy that I’m able to provide new hope for someone.
“There is really nothing to be afraid of. I don’t think the donation affected my health at all. It’s always a blessing to be able to give more,” she said.
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