Bone marrow donation: “Without a donor, I wouldn’t be here to talk to you today”


At the end of the line, Mélissa speaks in a small, tired voice. The sounds that come painfully from her mouth testify to the virulence of the treatments she is forced to take. Between a chemotherapy session and some home care, this 27-year-old communications officer tells her story. She looks back on the last fifteen years during which she had to fight against a genetic disease which causes her a deficiency in her immune system and complicates her daily life, but which she had ended up getting used to. And then this blow when, in October, he was diagnosed with lymphoma, a cancer of the immune system.

“Of course, it affected me a lot. I said to myself that between my illness and this cancer, I really had bad karma, she says a few months later. It’s stupid, but the first thing that touched me morally was to tell me that I was going to have to do chemotherapy and therefore lose my hair. Given her situation, the doctors who take care of Mélissa recommend, in addition to this particularly invasive treatment, a bone marrow transplant. The latter could as well cure his cancer as his autoimmune disease and allow him to find, in the long term, a life. “normal”.

A simple solution on paper that comes up against a more complex problem: finding a compatible donor. In theory, a sick person has a one in four chance of having a “biological identity card” – HLA system in medical jargon – close enough to that of his siblings for them to be compatible. This is not the case for Melissa. It remains to look in the register of bone marrow donors, which has just over 330,000 registered in France and 40 million worldwide.

One in a million chance

Problem: outside the family, the chances of finding a compatible donor are much slimmer and can go up to one in a million, depending on the rarity of their HLA system. Hence the need to have a maximum of people registered as donors to vary the profiles and increase the possibilities of finding someone compatible. “Once I was informed of the intention to be transplanted, a long wait begantestifies Melissa. We do not dare to ask doctors too much where things stand, whether or not they have succeeded in finding compatible donors. It is particularly difficult psychologically because we are in an urgent situation, but we know that the wait can last a very long time…”

On February 10, barely four months after the diagnosis of his lymphoma, the doctors finally announced to him that a compatible donor had been found. And that a transplant could be considered in the coming months. “I still have a hard time realizing it. For once, I was lucky, even if until the transplant is done, I don’t want to get the wrong ideas., she breathes. A “luck” that not everyone has.

For the past few weeks, Katinka Rambert-Cadré has been going from media to media. Rawthe Parisian, France 2, BFM-TV At each intervention, she tells the story of her son, Joseph, who was stricken at the age of 3 with leukemia which can now only be cured by a bone marrow transplant. The impossibility, until now, of finding any compatible donor. And therefore the need, both for her son and for other people with similar illnesses, for the French to register in numbers on the donor file to increase the chances of finding a compatible profile.

“Getting well informed, maturing your thinking”

The media coverage of Joseph’s story and the relay of many celebrities have made it possible for many to discover this still little-known gift, and thus to explode the pre-registrations of the French register of bone marrow donors. A godsend for the Biomedicine Agency, in charge of the French file, which seeks to register at least 20,000 new donors aged 18 to 35 each year.

However, much work remains to be done to explain to the general public the ins and outs of this donation, assures Release Dr. Evelyne Marry, who takes care of the registry: “It’s obviously very important to see new people interested in giving. But we find that many have pre-registered without really informing themselves, a bit on a whim linked to emotion. It is imperative to be well informed, to mature your thinking if necessary, having understood the meaning of this long-term commitment. Some think that by registering, they will be able to give directly to little Joseph, others that once registered, they will be able to give immediately. Which is not the case at all.”

Evelyne Marry recalls that a registered person takes an average of eight years before being called and that some are simply never contacted. That male profiles, largely in the minority in the register, are nevertheless privileged because the bone marrow of men is often better tolerated by patients. And that the donation is anonymous: the donor does not know to whom his bone marrow is intended, and the transplant recipient who gave it to him. They can nevertheless, after the transplant, exchange a few letters via the hospital services provided that they do not allow them to identify each other mutually.

“We leave as quickly as we arrived”

Finally, contrary to popular belief, bone marrow donation – often confused with spinal marrow – is far from being as restrictive as many may think. In 80% of cases, it is done by a simple blood sample, during which the bone marrow is filtered and extracted from the blood, as for a platelet donation. Count four hours at the time of collection, in addition to taking medication a few days before the donation. For the remaining 20%, which concern certain specific diseases and the pediatric sector, the sample is taken directly via a puncture in the pelvic bone and then requires a short operation under general anesthesia.

In any case, the donation is risk-free and the recovery is very fast. “For me, everything had happened very quietly, I had not had the slightest paintestifies Pierre, who donated bone marrow by puncture in his pelvis ten years ago. Once you have been called, there are some administrative procedures to do, during which you are accompanied. Then an appointment is made. We enter the hospital, the operation goes quickly, we stay one night under observation, and we leave as quickly as we arrived.

For transplant recipients, on the other hand, the process is much more cumbersome. “Before the transfusion, it first takes several months of heavy treatment and chemotherapy to destroy all the cancer cells.says Fabienne, transplanted in the spring of 2019 after leukemia. We also have to spend several weeks isolated, before and after the transplant, in a sterile room because we have no more white blood cells and therefore the slightest virus can be fatal to us. The side effects are also very unpleasant.”

A long and difficult course, but more than necessary, assures this 48-year-old teacher: “I am now three years post-transplant. I still have some problems and we can’t be 100% sure that I’m cured yet. But what we do know is that without a donor, I wouldn’t be here to talk to you today.”



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