Every 20 minutes, someone in the UK is told they have a blood cancer like leukaemia, lymphoma or myeloma.
A blood stem cell donation from a matching donor could save the lives of many people with a blood cancer or blood disorder. Here we explain what blood cancer is, why people get it and how matching donors are found.
Blood cancer is the fifth most common type of cancer in the UK, with someone being diagnosed every 20 minutes. Only 30% of the blood cancer patients in need of blood stem cell donation find a donor within their family. The rest rely on the odds of finding a match on the UK stem cell registry.
Finding a person with a matching tissue type for someone in need of a blood stem cell donation is not easy. With more than 17,000 known tissue characteristics, that can occur in millions of combinations, finding a matching donor can be like finding a needle in a haystack.
There are around 2,000 people in the UK searching for a blood stem cell donation each year and over 37,000 people waiting worldwide. The more people that register as a potential donor, the better chances for blood cancer patients of finding a match.
Are you, or is someone you know suffering from a blood cancer such as leukaemia, myeloma or lymphoma?
DKMS supports people with blood cancer and blood disorders. We work closely with patients and their families in appealing for more potential blood stem cell donors to join the register. We organise donor recruitment events of all sizes in different locations across the UK, from small community events to large events in multinational companies.
If you would like further information on how DKMS can support you or someone you know, please contact firstname.lastname@example.org
What is blood cancer?Blood cancer is an umbrella term for cancers that affect the blood, bone marrow and lymphatic system. Most of these cancers start in the bone marrow, where blood is produced. Stem cells in the bone marrow mature and develop into three types of blood cells: red blood cells, white blood cells or platelets. In most blood cancers, the normal blood cell development process is interrupted by uncontrolled growth of an abnormal type of blood cell. These abnormal blood cells, or cancerous cells, prevent the blood from performing many of its functions, such as fighting off infections or preventing serious bleeding.
There are three main groups of blood cancer: leukaemia, lymphoma and myeloma.
A lifesaving treatment optionBefore a person can receive a donation of blood stem cells from a suitable donor, they will be given high dosages of chemotherapy, and possibly radiation therapy in order to completely destroy all the diseased cells in their body.
How we find lifesaving donor matches
This is the challenging part! Even though there are over 27 million people on the worldwide register, this still isn't enough. Many people die because they are unable to find a matching donor.
LeukaemiaLeukaemia affects the white blood cells. These are an important, infection-fighting part of the immune system, made in the bone marrow. If somebody has leukaemia, an abnormal number of immature white blood cells are produced, which “clog up” the bone marrow and stop it from making other blood cells vital for a balanced immune system and healthy blood. Acute leukaemia comes on suddenly, progresses quickly and needs to be treated urgently. Chronic leukaemia develops more slowly, over months or years.
There are four main types of leukaemia:
• Acute myeloid leukaemia (AML)
• Acute lymphoblastic leukaemia (ALL)
• Chronic myeloid leukaemia (CML)
• Chronic lymphocytic leukaemia (CLL)
Lymphoma is a type of blood cancer that affects the lymphatic system, an important part of the immune system which helps to protect the body from infection and disease. If somebody has lymphoma, it means that too many lymphocytes, a type of white blood cell, are being made. The lymphocytes also live longer than they should. This overload compromises the immune system. Lymphoma can develop in many parts of the body, including the lymph nodes, bone marrow, blood, spleen and other organs.
The two main types of lymphoma are:
• Non-Hodgkin’s lymphoma (NHL)
• Hodgkin’s lymphoma (used to be called Hodgkin’s disease)
Myeloma Myeloma (also called multiple myeloma) is a blood cancer of the plasma cells. Plasma cells are found in the bone marrow and produce antibodies, which help fight infection. In myeloma, unusually large numbers of abnormal plasma cells gather in the bone marrow and stop it from producing an important part of the immune system. Myelodysplastic syndromes (MDS)
The myelodysplastic syndromes (MDS) are a group of blood disorders where a person’s bone marrow is not producing the correct amount and quality of blood cells. Red, white and platelet cells can be affected. These problems lead to people with MDS feeling very tired and weak and bleeding or bruising more easily. There are different levels of severity of MDS. It’s not a type of leukemia but can sometimes lead to acute myeloid leukemia. MDS is rare – about 4 in every 100,000 people get MDS. It mainly affects older people, and is more common in people over 70 years old.
Blood stem cells and bone marrow transplants can also be used to treat other than blood disorders, such as hemoglobinopathies and immunodeficiency syndromes, i.e. Thalassemia major, or sickle cell disease.
This high dose of treatment destroys their blood-forming cells in the bone marrow, to make room for the new stem cells. It also destroys the patient’s immune system so it cannot attack the donated stem cells. The donated blood stem cells move through the bloodstream to where they belong in the body and replace the patient’s unhealthy blood stem cells. They then settle into the bone marrow, where they engraft (begin to grow and produce red blood cells, white blood cells and platelets). The immune system and the blood system are closely linked, which means that they can’t be separated from each other. As a result, there could be some adverse effects, which affect the recipient. This may include the rejection of the donated stem cells (host-versus-graft-effect), or an immune reaction which causes the donor cells to attack the patient’s tissues (graft-versus-host-disease).A blood stem cell donation from an unrelated donor (allogeneic stem cell transplantation) can be a lifesaving treatment option for the following people with a blood cancer:
• Those at high risk of relapse• Those who don’t respond fully to conventional treatment such as radiotherapy or chemotherapy • Those who relapse after prior successful treatment
The immune and blood system are closely linked and can’t be separated from each other, so an allogeneic transplantation means that both the donor’s blood system and immune system are transferred.
When you join the registry your tissue type is determined using human leukocyte antigen (HLA) typing. HLA are proteins or markers found on all cells in your body. These proteins are used by your immune system to recognise which cells belong in your body and which cells do not. If these proteins do not match between donor and recipient, the person receiving a stem cell donation would reject the stem cells given by the donor. A close match means that the person’s immune system will recognise the donated blood stem cells as their own.The consultant treating the patient will look for a matching donor within the family first, but as only around one third of people with blood cancer find a suitable donor within their own family, the majority rely on the UK registry and the altruism of a stranger in their quest to find an unrelated donor.