Hematopoietic stem cell donation conveys life care
2024-11-15
Figure 1: Chinese bone marrow bank staff transporting hematopoietic stem cells. Figure 2: Chinese bone marrow bank staff conducting telephone follow-up with volunteer donors. Figure 3: In the hematopoietic stem cell collection room of Xiangyang Central Hospital in Hubei Province, three volunteer donors are collecting hematopoietic stem cells. Thank you, brother, for giving me a second life. After recovering from illness, I want to get out of bed and go out to play... "Recently, 3-year-old Ning underwent hematopoietic stem cell transplantation due to severe aplastic anemia. In the thank-you letter written by her parents to donor Xiao Xiao, Ning Ning expressed her feelings. Severe aplastic anemia can lead to bone marrow hematopoietic failure, with rapid progression and high mortality rate. Hematopoietic stem cell transplantation is the most effective treatment method. In addition to severe aplastic anemia, hematopoietic stem cells can also effectively treat diseases such as leukemia and lymphoma. In recent years, the technology of hematopoietic stem cell transplantation in China has been continuously improved, and many medical institutions have the conditions to implement it. At the same time, more and more volunteers are participating in the voluntary donation of hematopoietic stem cells, and their great love has brought hope to many patients' lives. According to data, as of October 31 this year, the China Hematopoietic Stem Cell Donor Database (hereinafter referred to as the "China Bone Marrow Bank") has a cumulative storage capacity of over 3.46 million people and has donated 18749 cases. The transplantation technology is mature and can treat various diseases. "I want to become a doctor who treats blood diseases and help more of my 'former self,'" said Xiao Chen, a master's student studying hematology at Zhejiang University School of Medicine. Mom, it seems like there's something wrong with my right eye 12 years ago, Xiao Chen, who was still in high school, found that he couldn't read the words on the blackboard clearly. His mother took him to the hospital for examination and found that there were bleeding symptoms in the right fundus. Subsequently, he underwent bone marrow puncture examination and was ultimately diagnosed with acute lymphoblastic leukemia. Accompanied by his parents, Xiao Chen came to the First Affiliated Hospital of Zhejiang University School of Medicine for treatment. After chemotherapy, Xiao Chen's condition improved slightly, but it soon recurred. Fortunately, Xiao Chen was successfully matched at the Chinese bone marrow bank and received treatment with unrelated hematopoietic stem cell transplantation. Two years later, Xiaochen returned to campus and took the college entrance examination. When filling out his application, he chose a medical major. After graduating from undergraduate studies, he chose to pursue a graduate degree in hematology. In the future, I can not only treat patients with blood diseases, but also encourage them with my own personal experience. Hematopoietic stem cells are the origin cells of all blood cells and immune cells, "said Jiang Tiebin, director of the Hematology Department at Xiangya Third Hospital of Central South University. Hematopoietic stem cells mainly exist in the bone marrow of the human body and have self-renewal, multi-directional differentiation, and homing (i.e. directed migration to hematopoietic tissues and organs) functions. It can not only differentiate and mature into red blood cells, white blood cells, and platelets, but also differentiate into cells of various tissues and organs across systems. Due to the short life cycle of mature cells such as red blood cells, white blood cells, and platelets in the blood system, hematopoietic stem cells play an important role in supplementing various mature cells in the blood system. Hematopoietic stem cell transplantation is the process of collecting hematopoietic stem cells from others, transplanting them into another person's body, and rebuilding a new hematopoietic system Dong Xiujuan, director of the Hematology Department at Hainan Women and Children's Medical Center, explained that bone marrow transplantation, commonly referred to as bone marrow transplantation, is medically known as hematopoietic stem cell transplantation. Prior to transplantation, patients should undergo high-dose chemotherapy and immunosuppressive pretreatment. By injecting mobilization agents into donors, hematopoietic stem cells in the bone marrow are released into the circulatory system, and then separated by a blood cell separator before being infused into the patient's body. Hematopoietic stem cell transplantation can treat various diseases. Jiang Tiebin said that hematopoietic stem cell transplantation can treat blood diseases such as leukemia, aplastic anemia, lymphoma, multiple myeloma, myelodysplastic syndrome, thalassemia, etc. It can also treat some non blood diseases such as some solid tumors, some inherited diseases, autoimmune diseases, etc. For some hematological malignancies, hematopoietic stem cell transplantation is the only cure. The hematopoietic stem cell transplantation technology system in China is already mature and at the forefront of the world. Jiang Tiebin introduced that Xiangya Third Hospital implements over 100 cases of hematopoietic stem cell transplantation every year. According to incomplete statistics, the success rate of hematopoietic stem cell implantation in China exceeds 90%, and some large hospitals even approach 100%. After successful implantation, the recovery situation is related to the patient's basic disease condition, the quality of the donor's stem cells, the control of graft-versus-host disease, and the anti-tumor effect of the transplant. However, overall, the success rate of cure has been significantly improved, "said Jiang Tiebin. The donation process is safe and the donor does not bear the cost. "Donating hematopoietic stem cells is like donating blood for a long time." After nearly 4 hours of hematopoietic stem cell collection, donor Song Lin's arms were sore. After the blood transfusion tubes inserted into both arms were gently pulled out by the doctor, he stretched lazily on the bed. The hematopoietic stem cells collected from Song Lin will be used to treat a leukemia girl. A few months ago, Song Lin received a notification that he had successfully matched a leukemia patient. He decided to donate hematopoietic stem cells. After passing the physical examination, Song Lin went to Beijing accompanied by staff from the China Bone Marrow Depot. The next day, he went to the PLA Air Force Characteristic Medical Center to get a mobilization dose. Afterwards, he returned to the hotel to rest. After getting vaccinated, it's time to eat and sleep. My body hasn't reacted much and I don't feel anything, "he said. Song Lin received mobilization medication for 4 consecutive days, and on the fifth day, he went to the hospital for hematopoietic stem cell collection. The collection process is also relatively simple. The doctor inserted a blood transfusion tube into each of Song Lin's arms, which was connected to a blood cell separator. The blood cell separator will separate hematopoietic stem cells from the blood flowing out of one transfusion vessel, and the remaining blood will be returned to Song Lin's body through another transfusion vessel. I was quite happy when I heard that the little girl's surgery was successful. I feel proud to be able to save a little life After donating hematopoietic stem cells for a few days, Song Lin's body fully recovered to normal. Donating hematopoietic stem cells will not cause harm to the body Jiang Tiebin said that in the past, due to technological limitations, it was necessary to perform bone marrow puncture surgery on donors in order to collect stem cells from their bone marrow, which would cause physical damage and psychological pressure to the donors. Nowadays, the vast majority of hematopoietic stem cell collection can be achieved by isolating stem cells from donor blood, with only 150 to 200 milliliters collected each time, which is less than the amount of blood donated at once. Huang Xianggang, Deputy Director of the Management Center of the Chinese Bone Marrow Bank, introduced that volunteers need to collect blood samples and undergo HLA (Human Leukocyte Antigen) typing testing before donation, and the data will be entered into the Chinese Bone Marrow Bank. Patients who require transplantation will have their matching requirements proposed by doctors, and the Chinese Bone Marrow Bank will assist in retrieving the matching. If the HLA high-resolution typing of the volunteer and the patient is confirmed to be consistent, and the volunteer passes the physical examination, they can enter the donation process. The donor does not need to bear any expenses. Donating hematopoietic stem cells is a great act of love Huang Xianggang said that non blood related hematopoietic stem cell donation and transplantation follow the principle of voluntary and gratuitous donation, reflecting respect for life. Each volunteer donor's donation target does not specifically refer to any individual, but transcends family or even national borders, facing the entire population. Both the supplier and the patient do not need to meet in person, ensuring necessary space isolation and no contact between the two parties. More and more volunteers are participating in hematopoietic stem cell donation. According to data from the China Bone Marrow Bank, a total of 2042 donations (including 14 from overseas) were made from January to October 2024, surpassing 2000 donations 41 days earlier than in 2023. Jiang Tiebin said that without hematopoietic stem cell transplantation, these patients' conditions would eventually deteriorate and be life-threatening. Donating hematopoietic stem cells can save patients' lives. Hematopoietic stem cells need to be successfully matched before transplantation. Dong Xiujuan explained that just as blood transfusion requires matching the correct blood type, hematopoietic stem cell transplantation requires HLA typing testing. For both the donor and patient, 9 or more of the 10 alleles need to be successfully matched before transplantation. Otherwise, the implantation of hematopoietic stem cells into the patient's body may result in severe rejection reactions, leading to transplant failure. In clinical practice, many patients rely on their relatives to transplant hematopoietic stem cells. Jiang Tiebin explained that according to the laws of genetics, generally speaking, brothers, sisters and parents can be used as donors for hematopoietic stem cell transplantation. Due to advances in transplantation technology, collateral relatives can now also become hematopoietic stem cell donors. However, there are still some patients who do not have suitable hematopoietic stem cell donors for transplantation and need to find non blood related donors to request matching from the Chinese Bone Marrow Bank. Due to the low success rate of matching, many patients can only wait. In 2000, the team led by Huang Xiaojun, director of the Hematology Department at Peking University People's Hospital, broke through the "forbidden zone" of international transplantation technology at that time and completed the first case of semi matched bone marrow transplantation. Subsequently, through more than 20 years of continuous efforts, based on more than 10000 clinical cases, the concept of "inapplicability" of semi matched donors in the world's medicine was changed, and the internationally recognized "Beijing Plan" for bone marrow transplantation was formed. Haploid bone marrow transplantation, also known as haploidentical transplantation, refers to a technique that allows patients to receive transplantation even when bone marrow stem cells are haploidentical. That is to say, when transplanting between parents and children, or between cousins, only partial HLA matching is required. This technology provides more treatment opportunities for patients who require bone marrow transplantation but cannot find a perfect match. In 2016, the World Bone Marrow Transplantation Association officially named this bone marrow transplantation technology system originally created by Chinese as the "Beijing Plan". At present, the Hematology Department of Peking University People's Hospital has become the world's largest haploid transplantation center. From a national perspective, the demand for non blood related hematopoietic stem cells exceeds the supply. The larger the number of volunteers in the Chinese bone marrow database, the higher the success rate of patient matching, "said Dong Xiujuan. How to join the Chinese Bone Marrow Bank? Cui Li, coordinator of the Medical Service Department of China Bone Marrow Bank, introduced that residents aged 18-45, in good health, without infectious diseases, and meeting the conditions for voluntary blood donation can become hematopoietic stem cell donors. Residents can apply to the staff at various voluntary blood donation points and complete the registration procedures by collecting a few milliliters of blood samples. We fully guarantee the rights of every volunteer and donor Donating hematopoietic stem cells is based on voluntary participation. After registering as a volunteer donor, the China Bone Marrow Bank will reconfirm the volunteer's voluntary status and closely protect the personal information of each hematopoietic stem cell donor. Du Dan, the head of the Medical Services Department of China Bone Marrow Bank, emphasized that in order to ensure the health of donors, comprehensive physical examinations and regular follow-up should be conducted before and six months after donation, and health insurance should be customized for each donor. (New Society)
Edit：Luo yu Responsible editor：Wang er dong
Source：people.cn
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