Articles

If You Could Make A Difference, Would You?

-------- Original Message --------
Subject: FidoNews submission.
Date: Tue, 13 Feb 2001 17:44:05 -0500
From: Ian Moote <diogenes@nas.net>
Organization: True Blue Computer Services
To: editor@fidonews.org

Nearly all of you can, but the statistics say that 97% of you won't and don't.

I was inspired to write this "article" by one of those formula Judao-Christian "inspirational" stories that appears in the FidoNews nearly every week. Specifically, it was the story in volume 18 number 3 about the boy with leukemia who, with his dying breath, asks the firechief if he's a fireman yet.

That's so sad, eh? Quite the tear-jerker. Oh well. He's dead. Next message.

Awww -- did that offend you?

Don't worry about it. This kid probably never existed anyway.

But there are real leukemia patients out there who are dying, and many of them are children. What would be your reaction if you discovered that you could save the lives of real leukemia patients!? YOU! And what if that would only cost you one to three hours of your personal time every month?

If you're like the lower 97% of the general population then please save yourself some time and just skip to the next article / message. If you consider yourself a member of the top 3% of the population then you may find something of interest within.

Leukemia

Leukemia is a cancer of the bone marrow and blood. We all know what bone marrow is but few people realize that bone marrow is actually a body organ, just like the heart, liver, or spleen. Bone marrow is responsible for producing a number of the components of our blood, such as the red cells which carry oxygen throughout our bodies, the white cells which fight infection, and the platelets which clot blood.

When the bone marrow becomes cancerous it begins to uncontrollably produce malformed and functionless cells. Yes, this is a bad thing and you do eventually die from it.

The prefered method of treatment seems to be to poison the diseased person. Toxins are injected into the body in an attempt to kill off the malignant marrow cells. The goal of treatment is to force the cancer into "remission". If the cancer remains in remission for a number of years then the patient is considered "cured".

In severe cases sometimes the leukemia patient doesn't have enough healthy marrow left to be treated successfully. In this case the only option is to kill off all of the bone marrow in the diseased person and replace it with healthy bone marrow. This replacement bone marrow comes from a healthy human donor. The problem is that bone marrow, being an organ, is easily rejected by the body and so a great deal of care must be taken to find an appropriate donor. The most likley donors, IIRC, are blood siblings. The next most likely are people from your blood family, the closer the better, then from your community/country. The farther removed from you, genetically, a potential donor is the less likely it will be that he will be able to provide an acceptable marrow donation. It is rare to find a potential "match" outside of one's ethnic group.

Unrelated Bone Marrow Donations

And this is where that 97% of you come in. The Red Cross keeps a registry of potential bone marrow donors which it calls the "Unrelated Bone Marrow Donor Registry". The procedure to be entered into the registry varies depending where you are. Up here in Canada the Red Cross (now the Canadian Blood Services) likes to see you make several whole-blood donations before they register you as a potential donor. When you want to become registered then you need to provide a seperate blood sample for screening. This initial screening establishes your HLA's and other factors which are used to determine potential matches.

At this point only enough information is obtained to determine if you are a potential candidate for any particular marrow transplant. If you are ever actually selected as a potential match then you will be called upon to provide one more sample so that it can be determined whether you are an actual match to the potential recipient.

The realities of bone marrow donation are:

1. Chances of a match are so rare that you'll probably never be called even as a potential match. IIRC, there's only a 1:4 chance of you being able to provide acceptable bone marrow for your own blood sibling.
2. The operation to actually extract the healthy marrow from the donor is apparently somewhat painful.
3. More than one donation may be necessary before the patient's body accepts your marrow.
4. If you're ever called upon then it may be necessary to put your life, family, and job on hold in order to provide the donation. Generally speaking you and the recipient will be in adjacent operating rooms at the time of donation, and because matches are so rare it is conceivable that you may have to travel half-way around the world to make your donation.
5. After all is said and done it may turn out that your marrow just isn't a close-enough match and the recipient repeatedly rejects it. As matches are so rare this will almost always result in the inevitable death of the recipient.

Plateletapheresis

But bone marrow donation is an extreme scenario. Leukemia is usually treated with chemotherapy. "Chemo" kills off much / most of the bone marrow, but not all of it. The idea is that the malignant marrow will likely be killed off and that any surviving marrow will be healthy.

This treatment usually works, but is not without its side-effects. Killing off the bone marrow results in reduced production of red, white, and platelet cells. Platelets are the cells which clot the blood and stop you from bleeding to death whenever you get a paper cut. Because of their reduced platelet production, chemo patients require platelet transfusions to maintain their platelet count.

These platelets can be taken from whole blood donations, but that can be somewhat wasteful as it requires four units of blood to produce one unit of platelets. Other components of the blood will be used for other purposes, but it's rare for all the separated components to be used. A more efficient method of obtaining platelets is from dedicated platelet donors.

Platelet donation is a lot like giving blood. The only real difference is that it's a lot more time-consuming. In a platelet donation only the platelets are extracted from your blood using a centrifuge. Your blood, minus the extracted platelets, is returned to your body. Your body replaces platelets so quickly that you can donate platelets every ten days. Such a small proportion of platelets are extracted that your body doesn't even miss them. Some donors regularly make double donations, depending on circumstances. (Just as an example, double-donations are common around Christmas time).

The only real problem with donating platelets is, as previously mentioned, the amount of time required. You can be hooked up to the centrifuge for 1.5 to 2 hours at a time. After you consider travel and sign-in time you're usually talking about three hours altogether. The Red Cross makes every attempt to spread donations across as many donors as possible. If you have a fairly common blood type and are CMV+ then it would be a bit unusual for you to be called more than once a month.

Platelet donations have a short shelf life. Platelets are harvested on an "as needed" basis for specific patients. Platelet donations, therefore, are much more serious than whole-blood donations. While both are certainly important, whole-blood donations (except for autologous, O-, or other special donation types) generally go into the general blood supply once they're processed; one disqualified unit of whole-blood is not normally missed. If you miss, cancel, or are disqualified from a platelet donation then a leukemia patient will quite possibly not receive his or her treatment.

If you can donate blood then you can donate platelets. The screening and qualification process is no different.

Whole Blood Donationsd

If you don't have the time or the bladder-control to donate platelets then donate whole blood! Most North Americans will require human blood products at some time in their lives, but only 3% of the population donates blood (a statistic which personally doesn't surprise me in the least).

Qualifications: Very basically, 18 - 60 years of age, fairly healthy, not a homosexual or bisexual male, no familial history of Creutzfeld-Jacob disease, not an IV drug user, not a recipient of blood products or dura mater grafts. Yes they take smokers and women who have had children. [:) You can donate a unit of blood every 56 days. (Just consider: in the time it takes one person to donate one unit of blood, a platelet donor has donated up to five units of platelets and saved twenty units of whole-blood for other uses!)

So the next time you read one of those inspirational tear-jerkers in the FidoNews, stop and ask yourself how you spent your free time today. Answer yourself honestly. Then take that answer and use it to determine whether you fit into the 97% who stand by and wank, or the 3% for whom lip service is just not enough.

"If you could make a difference, would you?"

Ian Moote 1:244/140

* Disclaimier: The author is not a doctor or nurse, and is not in the employ or affiliated with the Red Cross or the Canadian Blood Services. The information provided is from the author's own personal experience and recollection and is provided as introductory information only.