BONE MARROW INFORMATION:

Each year, many people in Australia and New Zealand are diagnosed with leukemia* or other serious blood disorders.  Often a bone marrow transplant is the only hope for a cure.

In Australia, the Australian Bone Marrow Donor Registry (ABMR) manages donors who are willing to donate their bone marrow or blood stem cells to patients with leukaemia and other blood disorders.

In New Zealand, this role is carried out by the New Zealand Bone Marrow Donor Registry (NZBMDR).

In the past, patients who needed a stem cell transplant received a “bone marrow transplant” because the stem cells were collected from the bone marrow.  Today, stem cells are usually collected from the blood, instead of the bone marrow.  For this reason, in many places, they are now more commonly called stem cell transplants.

Historically, 70% of people will not find a match within their family and will rely on a search of donors on the bone marrow registry.

The donor and the recipient must be a close genetic match based on “tissue type”.  Because tissue types are inherited, patients are most likely to match someone in their close family.  However, only one in three patients has a matched (tissue type) family member.

Only very close relatives of a patient will be tested for a specific person.  While you may be motivated because of someone close to you, the chance of you matching them is extremely low.  It is important to realise that there are many patients in need of stem cell transplants.  By joining the ABMR or the NZBMDR, you may be selected to help any patient, anywhere in the world.

If a match is not found in the family, a search for an unrelated donor may then be undertaken.

The patient is most likely to match someone with the same ethnicity or ancestral background.

In Australia and New Zealand, ethnically European patients have access to millions of European donors on worldwide registries, compared to a few thousand potential donors for Maori and Pacific Islanders.

For these reasons, we are targeting males of Maori and Pacific Island ancestry and people from other NZ ethnic minority groups.

If you’re male and your ancestors were Maori or Pacific Island (or any other New Zealand ethnic minority) you could be the match that saves a life.

The ABMDR and the NZBMDR are linked to a worldwide network of similar donor registries that can be searched for these patients.

The decision to become a bone marrow or blood stem cell donor requires careful consideration.  We hope this information will help you to make an informed decision.

How do I know if I am eligible to donate bone marrow?

You can join the ABM registry if you are aged between 18 and 45 years, in good health and meet the eligibility criteria found at www.abmdr.org.au.  To join, you need to live in Australia and be prepared to donate anonymously to any patient anywhere in the world.

You will be asked to complete a donor enrolment form, which includes questions about ethnicity and to confirm your eligibility.  You will need to indicate your family background on the enrolment form (for example, southern European or northern Chinese, Pacific Islander other than Maori).

Your tissue type, which is a way of making sure that you are compatible with patients, will be determined using a sample of your blood taken at the time of enrolment.  A sample will also be stored in case more detailed tissue typing is needed later.

At the time you apply to become a donor on the register, the Australian Red Cross Blood Service may also ask you if you would like to become a blood donor and make a blood donation.

Once you’ve enrolled The ABMDR won’t usually contact you unless you are identified as a potential match for a patient.  Your name will stay on the register for as long as you wish, however, donors are retired from the registry on their 60th birthday.

Donor selection

Your tissue type is entered into a national database, which is linked to the worldwide registries.  When a patient needs a donor, their tissue type is compared with all potential donors on the registries worldwide.  If you match with a patient, ABMDR will ask you to confirm your commitment to be a donor and to provide another blood sample to confirm this match.

In Australia, only one in 1,500 potential donors will be asked to donate bone marrow or stem cells in any year.

Your health and wellbeing before and after donation are very important to us.  If you are chosen to become a donor, an independent specialist with detailed knowledge of bone marrow or stem cells donation will assess you medically and answer your questions.  Donation occurs in one of the major hospitals in the state capital cities. You will not be required to travel overseas.

GENERAL INFORMATION ABOUT DONATING YOUR BONE MARROW

Bone marrow is the soft tissue found inside bones.  Bone marrow produces stem cells that in turn generate red blood cells, white blood cells and platelets.  If bone marrow is damaged or destroyed by diseases such as leukemia or other blood disorders, a stem cell transplant from a matching donor is the only possible treatment for many of these people to save their lives.

The donation must come from a person who matches the patient.  Searching for a donor from the same ethnic group as the patient greatly increases the chance of finding a match, so your ethnic background is important.

You can join the registry if you are aged between 18 and 45 years, in good health and meet the eligibility criteria.  To join, the ABMR you need to live in Australia and be prepared to donate anonymously to any patient anywhere in the world.

In New Zealand for further information please visit www.bonemarrow.org.nz.

Bone marrow is the tissue inside the bone cavity that produces stem cells which mature into all types of blood cells.  Bone marrow donation does not involve donating your actual bone but the collection of the stem cells which grow inside the bone.

In 2017, it was estimated that 3,875 new cases of leukemia would be diagnosed in Australia (2,358 males and 1,517 females).  In 2013, the age-standardised incidence rate was 13 cases per 100,000 persons (17 for males and 9.9 for females). Jun 19, 2017.

The 2016 census survey, the number of people in Australia claiming Pacific Islands ancestry (excluding Māori) is growing strongly both in absolute terms and as a proportion of the total population.  Those claiming Pacific Islands ancestry went from 112,133 in 2006 to 150,068 in 2011 to 206,673 in 2016 (The number of those claiming Māori heritage is a further 128,430 on top of this).  As a proportion of the total population of Australia, this group went from 0.56% in 2006 to 0.69% in 2011 to 0.88% in 2016.

(Note: This works out to ~0.013% of the total population and considering the information regarding the small number of current donors from this group in Australia, highlights the importance of this initiative).

Sources: https://leukaemia.canceraustralia.gov.au/statisticshttp://bellschool.anu.edu.au/ James Batley article on Pacific Islands Communities “In Brief 2017/13”.

A study of the ethnicity variables in the NZ population and their implications for stem-cell transplantation was published over ten years ago but is obviously still relevant:

New Zealand has a population of 4 million people comprising four main ethnic groups: Caucasian (72.9%), New Zealand Maori (14.7%), New Zealand Pacific Islands people (5.6%), and Asians (6.3%).

We examined 10 years of data (1993-2002) from the New Zealand Cancer Registry to determine if there are ethnic differences in leukemia incidence in New Zealand, and we relate this to the availability of stem-cell transplantation.

We found that New Zealand Asians have a generally lower incidence of all leukemias investigated.

New Zealand Maori have an increased risk of acute myeloid leukemia (RR 1.5 in the age group 25-49 and RR 1.31 in the age group 50-74), relative to New Zealand Caucasians.

New Zealand Pacific Islanders have an increased risk of chronic myeloid leukemia (RR 2.13 in the age group 25-49 and RR 1.52 in the age group 50-74).

Stem-cell transplantation is a standard curative treatment for ages 25-49, and current opinion is extending the acceptable age up to age 60, in certain cases.

We conclude that, among New Zealand Maori and New Zealand Pacific Islanders, there is an increased risk of acute myeloid leukemia and chronic myeloid leukemia in age groups suitable for stem-cell transplantation.

However, both ethnic groups have previously been shown to have a reduced chance of finding a 6/6-matched unrelated donor on international registries.

This leads to disproportionate provision of transplantation health care among the ethnic groups in New Zealand.

Source: https://www.ncbi.nlm.nih.gov/pubmed/15929115

Types of Donations

Peripheral Blood Stem Cell (PBSC) donation

Normally a very small number of stem cells from the bone marrow are circulating in your bloodstream.  To increase the number, a hormone-like substance called G-CSF is injected under the skin daily for four days prior to the procedure.  Blood is collected from a vein in your arm (like blood donation) and passes into a cell separator machine which removes the stem cells.  The rest of the blood is immediately returned to your body.  This procedure takes about three to four hours and does not require a general anaesthetic.  After this procedure you may go home.

What are the risks for me?

G-CSF is usually well tolerated, although during the course of the injections you may experience some bone pain and flu-like symptoms, which usually respond to paracetamol. G-CSF has been used in patients for many years.

The long-term effects of short treatments in normal donors appear to be safe.

Pelvic hip bone collection – In Australia, this is simply called bone marrow donation

Stem cells from bone marrow can also be collected from the pelvic hip bones using a needle and syringe under a general anaesthetic.  The procedure can take up to two hours.  Recovery time varies but donors are usually able to go home the next day and resume normal activities after two or three days.  Bone marrow re-grows rapidly to replace the donated cells.

What are the risks for me?

The risks of donating stem cells by this method are the same as the risks associated with a general anaesthetic.

To minimise the chance of any risks you will undergo a very careful screening process.  The chance of a serious complication in a healthy person is very low but some people experience nausea, bruising and/or local pain and discomfort for several days.

The spelling of the word leukaemia (or leukemia) is a matter of personal choice.  In non-medical circles, it seems most people in Australia spell it leukemia. As information on this website comes from various sources, you may notice the spelling change throughout the text. We have opted to leave the spelling as it appears in the source text.