Posted on June 3, 2010

Bone Marrow Transplants: When Race Is an Issue

Christopher Shay, Time, June 3, 2010

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{snip} The prospect of going through chemotherapy for a second time and needing a transplant is daunting to anyone, but it’s especially harrowing if {snip} you’re of mixed race. Multiracial patients often have an incredibly hard time finding life-saving marrow matches. When Devan, whose father is Caucasian and mother is part Indian, was first diagnosed with leukemia, his family did a search of the international marrow registry that contains over 14 million donors and came up empty. {snip}

Compared to organ transplants, bone marrow donations need to be even more genetically similar to their recipients. Though there are exceptions, the vast majority of successful matches take place between donors and patients of the same ethnic background. Since all the immune system’s cells come from bone marrow, a transplant essentially introduces a new immune system to a person. Without genetic similarity between the donor and the patient, the new white blood cells will attack the host body. In an organ transplant, the body can reject the organ, but with marrow, the new immune system can reject the whole body.

To find a marrow match for anyone is hard. Even within one’s own family, the chances of finding one are only about 30%. According to the World Donor Marrow Association, while two out of three Caucasians find a match, the chances of a patient from another ethnic background can be as low as one in four. Despite rapid improvements in marrow registries around the world, the global registry is still disproportionately represented by the U.S., U.K. and Germany–all predominantly Caucasian countries. For a multiracial person, the chances are usually even worse. Athena Mari Asklipiadis, the founder of the California-based Mixed Marrow, one of the only outreach groups devoted to recruiting mixed race donors, says “the numbers are quite staggering. . . . {snip}”

It’s difficult to ascertain the exact chances of finding a match for a mixed race person because the different combinations have different success rates, and the U.S.-based National Marrow Donor Program (NMDP), which has about eight million donors in its registry, does not have statistics on the success rates of mixed race patients. But Asklipiadis maintains the rates are lower–much lower. {snip}

In the NMDP database, less than 3% of donors self-identify as mixed race. Though this approximately matches U.S. Census data, more mixed-race donors are needed given the sheer genetic diversity of the group. {snip}

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