Saving a stranger

An English expat living in Singapore, ZOË HAWKINS was surprised last year by a call from the Bone Marrow Donor Programme (BMDP) – Singapore’s only register of volunteer marrow donors – asking her to donate bone marrow.

It had been more than six years since she’d put her name on the registry at a sign-up drive organised in a friend’s function room – and it was a distant memory. “My friend’s family friend had leukaemia and obviously you just want to help in any way you can,” says Zoë of adding her name to the list back in 2014. “When you finally get the call, you think, ‘Oh, okay, I never thought I’d actually be called upon!’” It turned out Zoë was a match for a leukaemia patient, somewhere in the world, whose only chance for survival was to have a bone marrow transplant.

Found inside the hollow spaces of large or long bones, bone marrow contains stem cells that produce red and white blood cells, and platelets. Patients with various blood disorders, including leukaemia – a cancer causing rapid production of abnormal white blood cells in the bone marrow – are unable to produce healthy blood cells or the right combination of such cells. Therefore, a bone marrow transplant (also known as a stem cell transplant), which is often a last chance of survival, is done to infuse healthy blood-forming stem cells into the patient’s body to replace damaged or diseased marrow.

Oftentimes, siblings can be matches. But, according to the BMDP, less than one in three patients can find this sibling match. That’s why an international database is used so that organisations can cross-reference donors; it’s key to identifying necessary matches.

Because the chances of being a match to someone you’re not related to vary widely depending on the rarity of the patient’s tissue type, Zoë knew she had to seriously consider the opportunity to save someone’s life.

How to donate bone marrow

There are two methods for bone marrow donation, and donors can opt for their preferred method (with no expenses paid by the donor).

One is a Bone Marrow Collection, where bone marrow is removed from the back of the pelvic bone using a special needle. Though there is no surgery involved, the procedure is done under general anaesthetic and the donor must stay overnight in the hospital.

Keen to avoid the downtime that can come with recovery from general anaesthetic, Zoë opted for the other method: Peripheral Blood Stem Cell Collection. This is an outpatient procedure in which stem cells are collected from a donor’s bloodstream; blood is drawn from one arm and passed through a machine that separates the blood stem cells. The remaining blood is then returned through the other arm. According to the BMDP, 90 percent of donors choose this donation process. Though there is no downtime and normally no hospital stay involved, the donor must prep his or her body for four days leading up to and on the day of stem cell collection with daily injections to stimulate the production of blood stem cells.

Admittedly, Zoë didn’t feel her best during the few days leading up to the stem cell collection. The daily injections (administered by her GP, as she didn’t want to inject herself) made her feel as though she had a bit of a flu. Still, it was nothing bad enough to stop her from doing her daily activities (“I just had a few more naps!”).

“The rougher you feel, the better. It’s a sign your body is doing what it’s supposed to,” she says. “Also, you ache in your hips because that’s where the bone marrow is primarily.”

On the day of the stem cell collection, Zoë was linked to a machine while lying in bed. With a line in and line out, blood was taken out of one arm and put in a machine that filters out the blood stem cells. Throughout the day, the bags filled up, and the remaining blood was sent back into her other arm (“It’s like a very long blood test!”).

“It was incredible to see what the body can do – and what the machine can do,” says Zoë. For her, it took seven hours to get the right amount of white blood cells and plasma needed for the recipient.“I was linked up at about 8am and done by around 4pm. Everything was sent to the lab at 4.30pm, and by 6.30pm we knew there was enough. I was at home on my sofa by 8.30pm!”

Though she was a bit sore and tired in the days following the procedure, Zoë says she could still do everything she needed to do. “In the end, it was just 12 hours in the oncology ward. It was really nice to do something meaningful and it was really nice to do something to help people,” she says. “I was on such a high – I was the lucky one because I was a match.”

She adds, “It’s really humbling spending a day in an oncology ward. It puts things in perspective, especially living here in Singapore where we tend to be so spoiled and take things for granted.”

How you can help donate bone marrow

“It’s important to hear from someone who’s done it,” says Zoë; “to hear them say, ‘Yeah, it’s uncomfortable, but it’s not unbearable; it’s a bit scary, but not too scary.’ She would do it again in a heartbeat to save a life, too.

While it may seem like a bizarre concept to some – after all, it is volunteering to help a stranger despite the discomfort and inconvenience – this act of kindness can be the difference between life and death for a patient, and a beacon of hope for the patient’s family.

In Singapore, anyone in good health between the ages of 17 and 49 can sign up as a marrow donor. To register, you can apply online at bmdp.org/be-adonor. Normally, a kit will be sent to your home and all you need to do is a simple cheek swab and mail it back. However, due to the COVID-19 situation, the BMDP team will not be dispatching swab kits until the situation improves. Nevertheless, it’s still a great idea to put in a request, and the team will be in touch.

In the event that you’re identified as a match, a BMDP coordinator will get in touch to answer any questions; in fact, the coordinator will be with you every step of the way.

To find out more, visit bmdp.org

This article first appeared in the June 2020 edition of Expat Living. You can purchase a copy or subscribe so you never miss an issue!