There has been a lot of press coverage lately about bone marrow transplants and stem cell therapies, from politicians calling for an overhaul of the way Australians can register to become bone marrow donors, to heartbreaking stories of life-saving bone marrow donations being left on the tarmac instead of being put on the plane bound for Brisbane, and the young boy waiting to have a transplant. In short, a lot of press time for something so tiny you can’t even see it. (Haematopoietic stem cells are a mere 7 μm in diameter). They’re something most of us never even think about… until, that is, they’re not working properly anymore.

But what even is a haematopoietic stem cell?

Haematopoietic Stem Cells (HSC)

Haematopoiesis [pronounced “heema-to-po-EE-sis”, or sometimes “heema-to-po-E-sis”, with a short E sound] is the formation of all the cells in our blood. Haematopoietic [pronounced “heema-to-po-Etic” or “heema-to-po-EEtic”] stem cells are the cells that turn into all the different types of cells in blood. You’ll sometimes see them referred to as blood stem cells. These haematopoietic stem cells are found in our bone marrow, where they make new blood cells for us all the time. These blood cells do all sorts of jobs in our bodies, like carrying oxygen from the lungs to our muscles, removing waste products from our tissues, and fighting disease.

Sometimes, though, the process of making new blood cells gets disrupted, and the production of blood cells doesn’t happen like it should. This can result in an immune system that is unable to fight disease. In the case of blood cancers and some other blood-related disorders, a bone marrow or stem cell transplant offers the best hope for a cure.

How do you collect haematopoietic stem cells?

So, if these particular stem cells are found in bone marrow, doesn’t that mean that you have to be able to get at your bones to harvest them?

Well, sometimes.

Occasionally HSC are taken directly from the bone with the donor under a general anaesthetic.

More commonly, though, these stem cells are collected directly from the blood stream of the donor in a process called apheresis. The donor is given some medication that stimulates their healthy bone marrow to produce more HSCs than usual, and push them out into their blood stream. The cells are then collected from a vein much like giving blood. The main difference to a straight blood donation, though, is that only the stem cells are collected, and the rest of the donor’s blood is then returned to the donor.

What’s the state of play with bone marrow donations in Australia?

Currently in Australia, you can become a bone marrow donor through Australian Red Cross Lifeblood. When you go to Lifeblood to make a blood donation, you can scan a QR code and register as a bone marrow donor. When you donate blood, they take a sample to test for your tissue type, which then becomes part of the registry database, and is searchable both within Australia and around the world. According to the Australian Bone Marrow Donor Registry (ABMDR) we need 20,000 new donors on the register each year to improve the chances of people in need of stem cells in Australia to be able to find an Australian donor.

Elsewhere around the world, it’s common for people to be able to join a bone marrow registry through a simple cheek swab, and for several years now the ABMDR have been asking governments to allow the use of cheek swabs as a method of joining the registry. The ABMDR even ran a trial of postal cheek swabs and found it to be simple and effective, but it is still not accepted as a way of recruiting donors in Australia. However it does appear that progress is being made, with recent promises by government to reduce the red tape to give Australian patients the best chance to access a life saving bone marrow donation.

What does the small size of our donor pool mean for Australians needing haematopoietic stem cell transplants?

The small size of our bone marrow donor pool means that 8 out of 10 Australians needing a bone marrow transplant have to search globally for a donor, according to the ABMDR website. This means that 8 out of 10 critically ill people and their families worry about whether they will find a match, and whether something might go wrong logistically in shipping the precious cells from overseas.

Who can become a donor?

You can help by becoming a donor. If you are ages 18-35 years, and are healthy, and able to donate blood, you can register the next time you visit Lifeblood Centre for your blood donation. If you fall within that age range, but are not eligible to give blood, you can call Australian Lifeblood on 13 14 95 to discuss your options.