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Page 1: Introduction
Title: Stem Cell Transplant: Why Your Donation Matters
Author: Prateek Lala, MD
Organization: South Asians for Life (SA4L)
Date: June 2014
Page 2: What is Leukemia?
Definition: A malignant cancer affecting bone marrow and blood.
Origin: Develops from a bone marrow stem cell that grows uncontrollably.
Consequence: Crowds out normal bone marrow cells, disrupting normal blood cell production.
Page 3: Types of Leukemia
Common types in adults include:
Acute Myelogenous Leukemia (AML)
Acute Lymphocytic Leukemia (ALL)
Chronic Myelogenous Leukemia (CML)
Chronic Lymphocytic Leukemia (CLL)
Characteristic: Acute leukemias progress rapidly and require urgent treatment.
Page 4: Leukemia Treatment
Treatment is personalized and may include:
Chemotherapy
Radiation therapy
Stem cell transplantation
Page 5: What are Stem Cells?
Definition: Cells that can develop into various other cell types.
Function: Bone marrow stem cells generate all types of blood cells:
Red blood cells (oxygen transport)
White blood cells (immune function)
Platelets (clotting)
Page 6: Types of Stem Cells
Distinction: Not embryonic stem cells; derived from consenting adult donors.
Usage: Stem cells used in transplants come from blood or bone marrow.
History: Technology has been in use for approximately 40 years.
Page 7: Stem Cell Transplant Process
Requirement: A suitable source of stem cells needs to be identified.
Matching: Finding a donor whose HLA markers are similar to the patient's.
Page 8: HLA Matching in Populations
Likelihood: Patients can find matches more easily within their own ethnic communities due to similar HLA patterns.
Registries: National and international HLA registries are searched for matches, especially for patients without family matches.
Page 9: Representation in Registries
Issue: Ethnic minorities are underrepresented in stem cell registries.
Implication: Patients from these groups have a lower chance of finding suitable donors.
Statistics:
Japanese American: 99%
African American: 50%
North American Caucasian: 93%
Asian: 50%
Page 10: Canadian Registry Overview
Organization: OneMatch Stem Cell and Marrow Network, managed by Canadian Blood Services.
Registration Status: As of December 2013, there are 329,285 registered individuals in Canada.
Page 11: Ethnic Representation in Registries
Ethnic compositions in OneMatch registry:
Caucasian: 71.5%
East/SE Asian: 11.2%
South Asian: 4.8%
Other: 12.5% (includes various minorities like Black, Arab, Latin/Hispanic)
Page 12: OneMatch Registration Information
Registration methods:
Online at www.onematch.ca.
Phone: 1-888-2DONATE (236-6283).
Cost: Free for Canadian residents with a provincial health card.
Page 13: Donor Eligibility
Criteria for donors:
Age: 17-35 years.
Good health condition.
Willing to donate to any patient in need.
Focus on recruiting ethnic males for better outcomes.
Page 14: Registration Process
After online registration, donor will be contacted for follow-up.
A cheek swab kit will be sent for HLA marker DNA analysis.
Page 15: Swab Kit Instructions
The kit provides detailed instructions.
Collection time: Approximately 10-15 minutes.
Page 16: Swab Collection Procedure
Step-by-step instructions on collection:
Fill out identification and date on requisition form.
Label each swab correctly including the collection date.
Collect samples from four areas of the cheek.
Mail completed samples to Canadian Blood Services.
Page 17: Sample Analysis
Result Timeline: Samples analyzed in about 3-4 weeks.
Importance of updating contact information for match notification.
Page 18: Match Notification Process
OneMatch only contacts if a match is found.
Donations can be for Canadian or international patients.
Page 19: Conditions Treated with Stem Cell Therapy
Cures various diseases:
Cancers (leukemia, lymphoma, myeloma)
Bone marrow diseases (sickle cell anemia, thalassemias)
Immune disorders (severe combined immunodeficiency).
Page 20: Stem Cell Donation Procedures
Main sources of stem cells:
Peripheral Blood Stem Cell (PBSC)
Bone marrow
PBSC is the most common method, used in 85% of collections in Canada.
Recovery time post-donation is minimal (a few hours).
Page 21: Donor Responsibilities
The physician decides the collection method.
Donors can choose to accept or decline donations.
Page 22: PBSC Donation Process
Donors receive 4-5 days of G-CSF to mobilize stem cells.
Possible side effects include:
Mild bone pain
Fever/chills
Nausea
Local irritation.
Side effects typically resolve shortly after stopping G-CSF.
Page 23: Related Experience
Reference to Steven McEvoy's donor experience article.
Page 24: Bone Marrow Harvest Process
Procedure involves:
General or regional anesthesia.
Needle insertion into the hip bone to extract liquid marrow.
Marrow replenishes in 4-6 weeks.
Page 25: Bone Marrow Extraction Equipment
Tools used during extraction.
Page 26: Side Effects of Bone Marrow Harvest
Common side effect: pain in hip bones at collection sites, manageable and lasts a few days.
Page 27: Stem Cell Administration
Harvested stem cells are processed and administered intravenously to the patient.
Page 28: Transplant Versus Chemotherapy Outcomes
Long-term survival rates for leukemia patients:
Stem cell transplant: 40-64%
Chemotherapy: 19-24% (improved in recent studies).
Page 29: Confidentiality in Donation
Personal information is kept confidential.
Donor and recipient identities are anonymous.
Donors may withdraw until just before donation.
Page 30: Post-Donation Information
Donor can receive updates on patient’s post-transplant status.
Possibility of exchanging letters or meeting one year later if both agree.
Page 31: Additional Ways to Help
Encouragement to consider:
Blood donation.
Monetary support.
Page 32: South Asians for Life (SA4L)
Established in 2008 to promote awareness and participation in stem cell donations among South Asians.
Significant additional registrations due to their efforts.
Page 33: Resource Slides
General resource information.
Page 34: Blood Cell Development Overview
Outline of blood cell development from myeloid and lymphoid stem cells.
Page 35: Understanding HLA
Explanation of human leukocyte antigens (HLA) in the body.
Role: Prevent immune system from attacking its cells.
Page 36: HLA Inheritance
HLA markers are inherited from parents, creating matching probabilities among siblings.
Only 30% of patients find family matches; 70% rely on unrelated donors.
Page 37: Complexity of HLA Markers
Description of HLA marker diversity and matching complexity.
Page 38: Important HLA Markers
Key HLA markers for donor matching along with their variants and implications.
Page 39: PBSC Collection Technique
Process overview involving apheresis unit for stem cell separation.
Page 40: PBSC Collection Outcomes
Patient experience is typically painless; recovery to normal levels takes 3-6 weeks.
Page 41: Bone Marrow Harvest Reference
Visual reference and sourcing for bone marrow harvest information.
Page 42: Cord Blood Donation Overview
Explanation of cord blood as an alternative stem cell source.
Options for parents: Public vs. Private Registries.
Page 43: Cord Blood Donation Process
Steps involved in cord blood collection, purification, and preservation.
Page 44: OneMatch and Cord Blood Donation Services
Overview of available public cord blood registries in Canada as of 2014.
Page 45: U.S. Donor Registries
Largest registry overview and demographics of registered donors.
Page 46: Indian Registries
Information on three existing stem cell registries in India and contact details.
Page 47: International Registry Overview
Statistics on global stem cell donor availability and registry information.
Page 48: Historical Timeline of Stem Cell Developments
Milestones in the history of stem cell treatment and donor matching.