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Ethnic minorities' stem cell donor match rates double in 15 years Ethnic minorities' stem cell donor match rates double in 15 years
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Rates of black and ethnic minority people finding stem cell donors for blood cancer treatment are approaching those of white people after years of lagging behind, a study has found. Rates of black and minority ethnic (BME) people finding stem cell donors for blood cancer treatment are approaching those of white people after years of lagging behind, a study has found.
Over the past 15 years the chances of BME patients finding a match on the register of volunteer donors prepared to give stem cells has approximately doubled from 30% to 60%, reflecting an enormous growth in donor registrations in recent years, according to research for the blood cancer charity Anthony Nolan. Over the past 15 years, the chances of BME patients finding a match on the register of volunteer donors prepared to give stem cells has doubled from 30% to 60%, reflecting an enormous growth in donor registrations in recent years, according to research for the blood cancer charity Anthony Nolan.
That figure is still significantly short of the likelihood of white, northern European people finding a match on the register, which stands at 96%, but recent scientific developments in harvesting stem cells from umbilical cord blood and using "half-match" cells from family members mean that, overall, BME patients now stand an equal chance of reaching transplant, the study shows.That figure is still significantly short of the likelihood of white, northern European people finding a match on the register, which stands at 96%, but recent scientific developments in harvesting stem cells from umbilical cord blood and using "half-match" cells from family members mean that, overall, BME patients now stand an equal chance of reaching transplant, the study shows.
"It's been a really big shift," said the report's author, Dr Robert Lown, of Anthony Nolan and the University College London Cancer Institute. "Fifteen years ago people who were not white were really struggling to find donors to get transplants. Even though more people were registering, most of the people on the registers were white. It has changed a lot." "It's been a really big shift," said the report's author, Dr Robert Lown, of Anthony Nolan and the University College London Cancer Institute. "Fifteen years ago, people who were not white were really struggling to find donors to get transplants. Even though more people were registering, most of the people on the registers were white. It has changed a lot."
The ideal match for people with blood cancers such as leukaemia is a sibling, but they only prove to be a perfect match in one out of four cases. If a patient does not have a matched sibling donor then the next step is to look at donor registers. Experts analyse genetic markers, which are strongly linked to ethnicity, to determine the best donor for each patient. The ideal match for people with blood cancers such as leukaemia is a sibling, but they are only perfect match in one out of four cases. If a patient does not have a matched sibling donor then the next step is to look at donor registers. Experts analyse genetic markers, which are strongly linked to ethnicity, to determine the best donor for each patient.
The low number of BME donors on registers around the world historically has made finding a suitable life-saving match difficult. Lown studied the cases of 332 patients in the UK who were referred to the Anthony Nolan donor selection service, comparing waiting times and donor match-up rates. The findings were presented to the American Society of Haematology's annual conference.The low number of BME donors on registers around the world historically has made finding a suitable life-saving match difficult. Lown studied the cases of 332 patients in the UK who were referred to the Anthony Nolan donor selection service, comparing waiting times and donor match-up rates. The findings were presented to the American Society of Haematology's annual conference.
He found that despite an upsurge in donations, BME patients were at least five times more likely to need a cord or haploidentical (half-match) transplant due to a lack of a suitable registered donor. Both techniques, which have become prevalent in the UK only in the past 10 years, require less of a tissue match than traditional transplants, making them easier to find. He found that despite an increase in donations, BME patients were at least five times more likely to need a cord or haploidentical (half-match) transplant due to a lack of a suitable registered donor. Both techniques, which have become prevalent in the UK only in the past 10 years, require less of a tissue match than traditional transplants, making them easier to find.
Although a welcome development, Lown said contemporary studies suggested that a match still offered the best outcome for patients. "This is great because it's very good that we can give people the opportunity, but we want to give people the best opportunity," he said. "We need to increase the numbers on the register and particularly we need to increase the ethnic diversity of the register." Although a welcome development, Lown said contemporary studies suggested that a match still offered the best outcome for patients. "This is great because it's very good that we can give people the opportunity, but we want to give people the best opportunity," he said. "We need to increase the numbers on the register and particularly we need to increase the ethnic diversity of the register."
Henny Braund, the chief executive of Anthony Nolan, said: "We are determined to continually improve the survival chances for patients from ethnic minority backgrounds and this report shows that the battle is being slowly won. However, we must always be looking to increase the chances of people finding a life-saving match, wherever they come from, and there is much work to still to be done." Henny Braund, the chief executive of Anthony Nolan, said: "We are determined to continually improve the survival chances for patients from ethnic minority backgrounds and this report shows that the battle is being slowly won. However, we must always be looking to increase the chances of people finding a life-saving match, wherever they come from, and there is much work still to be done."
Case studyCase study
Six-year-old Sara Mhlanga, from Belfast, first became unwell in the runup to Christmas 2007. After being moved to a specialist hospital in Bristol in February 2008, she was diagnosed with a myelodysplastic syndrome, which progressed quickly to an acute form of leukaemia. The doctors told Sara's mother, Ewa, and father, Dereck, that she urgently needed a bone marrow transplant to survive.Six-year-old Sara Mhlanga, from Belfast, first became unwell in the runup to Christmas 2007. After being moved to a specialist hospital in Bristol in February 2008, she was diagnosed with a myelodysplastic syndrome, which progressed quickly to an acute form of leukaemia. The doctors told Sara's mother, Ewa, and father, Dereck, that she urgently needed a bone marrow transplant to survive.
However, because of Sara's mixed heritage – Ewa is Polish and Dereck from Zimbabwe – it was impossible to find a match on any register in the world. By the summer, doctors said they could no longer wait for a suitable donor and decided to use an umbilical cord blood transplant, which does not require the same degree of match-up to work.However, because of Sara's mixed heritage – Ewa is Polish and Dereck from Zimbabwe – it was impossible to find a match on any register in the world. By the summer, doctors said they could no longer wait for a suitable donor and decided to use an umbilical cord blood transplant, which does not require the same degree of match-up to work.
Anthony Nolan found a cord match in Dusseldorf, Germany. On 18 August 2008, Sara had the transplant. It was successful and she was allowed home in October of that year. Now 12, Sara is doing well and in August this year she visited Bristol with her family to mark the fifth anniversary of the transplant.Anthony Nolan found a cord match in Dusseldorf, Germany. On 18 August 2008, Sara had the transplant. It was successful and she was allowed home in October of that year. Now 12, Sara is doing well and in August this year she visited Bristol with her family to mark the fifth anniversary of the transplant.
"We knew how lucky we were; it was so difficult to find a match and some of the children who were in the same ward as Sara didn't survive," said Ewa. "Now we just have six-month checkups. Life has returned to normal, and she loves reading and playing the cello. We are just so grateful to everyone, and we will be eternally grateful to every mother who donates their cord blood, because it could save someone like it saved our Sara.""We knew how lucky we were; it was so difficult to find a match and some of the children who were in the same ward as Sara didn't survive," said Ewa. "Now we just have six-month checkups. Life has returned to normal, and she loves reading and playing the cello. We are just so grateful to everyone, and we will be eternally grateful to every mother who donates their cord blood, because it could save someone like it saved our Sara."
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