Declaring that men are better than women can land you in hot water. But a new campaign launched this week by the Anthony Nolan Trust, a leukaemia charity, says exactly that. The reason for this risky statement is that men make better bone marrow donors, but the trust’s register, which is one of the largest lists of donors in the UK, is full of women.
A survey from the trust this week revealed that a third of men think that donating bone marrow is too painful; a quarter said they were frightened of needles; and half said that they don’t understand what it involves. However, their fears are unfounded because in the past five years bone marrow donation has been transformed. It used to involve a general anaesthetic, sucking out the marrow with a large needle, and a recuperation period that felt as if you’d fallen hard on ice for days after. Today, three quarters of all bone marrow donations are a similar procedure to giving blood, and just as painless.
In the week when the poisoned former KGB spy Alexander Litvinenko, highlighted the need for donors, with 7,000 people worldwide desperately waiting for a transplant, perhaps it’s time for blokes to step forward, says Dr Steve McEwan, the chief executive of the Anthony Nolan Trust. “Becoming a bone marrow donor gives you the possibility of providing the greatest gift to a stranger, the gift of life.”
Children and adults need transplants when their bone marrow, and therefore their ability to make blood cells, has been affected by diseases such as leukaemia, genetic disorders, and immune system failures. Only one person in four can find a match within his or her family. The rest have to rely on a bone marrow register.
The Anthony Nolan Trust had 929 requests for transplants last year and the British Bone Marrow Registry (BBMR) received 2,000. Although there are about 300,000 potential donors on both lists, the BBMR matched only 200 and the Anthony Nolan Trust 300. People’s biological make-up is so different that it’s incredibly hard to find a match.
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So, why do men make better donors than women? Dr McEwan says it is because men are bigger, they produce more stem cells, and more cells mean a more successful transplant. Three-quarters of all transplants are from men (even if the recipient is a woman), but they make up less than half of the register.
However, the Anthony Nolan Trust does not reject female donors. On the whole, the more donors, the better the chance of finding a match. The trust especially needs people from ethnic minorities, and young people, as stem cells from under-30s are more likely to make successful tranplants.
“We’ve been running for 30 years and our register is getting older. We’re losing about 8,000 donors a year through age; we use them up to the age of around 45. People over 30 seem more willing to donate, perhaps because they have families. But with the younger age group we need to get our message across in different ways,” says Dr McEwan.
One of these ways may be to tell people about the new method of taking bone marrow. The idea is to harvest stem cells from a donor and to give them to someone whose bone marrow is no longer producing them because of illness or cancer treatment. Under the new procedure, the donor’s stem cells are coaxed out of their marrow by a hormone, which is injected into the bloodstream. Over four hours, the donor’s blood is taken from one arm and, filtered for stem cells before it flows into the other arm in a continuous circuit. By the end of the treatment there will be a neat little bag of cloudy-pink liquid containing stem cells, which, after a couple more filters, the recipient will receive via a drip.
Sarah Lee, a public affairs consultant, who has given bone marrow this way, says it’s no worse than giving blood. She had forgotten that she had signed up to the BBMR register when she got the call telling her that she was a match for someone on the transplant waiting list. After blood tests and a compulsory counselling session to fill her in on the risks, she started the hormone injections — six in total, two a day for three days before she donated.
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“A nurse gives injections at home or in the office, and stays with you for an hour to make sure that there are no side-effects, such as an allergic reaction,” Lee, aged 30, says. The injections can make donors feel achey, as if they have a cold. “My thighs and back were a bit sore,” Lee says, “but I took some paracetamol and then went to the cinema.”
The procedure took place at the Royal Free Hospital, North London. “I was nervous and a nurse stayed with me the whole four hours. It was quite a strange moment when they packed the cells in a green cool-bag and took them away. I realised that they were someone’s life-saver and got a bit choked up. I wanted to stay in blissful ignorance and not contact the recipient, but even if I had wanted to, it was out of the question and not allowed.” After a day’s recovery, Lee was back at work.
About one person in five has to come back a second day if enough cells aren’t collected, and, in rare cases, more cells are extracted with a needle under anaesthetic.
Dr Paul Travers, the head of research for the Anthony Nolan Trust, says joining a register requires some thought. “Everybody has to agree that if, as in a small number of cases, the blood doesn’t contain enough stem cells for transplantation they will do it the old-fashioned way.”
Lee would happily step up again: “Everybody knows someone who has been affected by cancer and I know how desperate I’d be for a match on the register if it was my loved one.”
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The Anthony Nolan Trust, www.anthonynolan.org.uk, 020-7284 1234; the British Bone Marrow Register, www.blood.co.uk, 0845 7711711
Transplant figures
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2000 UK requests for transplants that the British Bone Marrow Registry received last year
200 UK matches were found
50% Survival rate after bone marrow transplant
2:3 The ratio of men to women on the Anthony Nolan Trust bone marrow register
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4 Hours is the average time it takes to donate bone marrow from the blood; the old method involved an overnight stay