Sex with leukemia is often stored with bone marrow from abroad

Although the highest criterion is to find the most suitable donor regardless of origin, more Czechs are needed.

“We have 60 per cent donors from abroad. Not because there are few of them, but because we are a small country, genetic variability is low,” Marie Kurikova, head of the Czech Registry of Hematopoietic Cell Donors at IKEM, told Prav.

A similar trend is observed in other countries. For her, increasing the role of sex might help. Last year’s balance shows how vital Germany is for Czech patients. Most of the donors are from here or from Poland. 81 percent of bone marrow transplants are from a foreign donor. Only 18 percent of the Czech donor went to the Czech patient.

“Doctors always choose the most suitable donor and do not look at the nationality. Of course, it would be better if a third to a quarter were from our register. It is cheaper and logistically much easier. But we will never reach that 60 percent,” said Pilsen General Hospital. Hemato-oncologist Pavel Jindra, head and chief physician of the Czech National Registry of Bone Marrow Donors, told Prav. There are two registers in the Czech Republic, Pilsen and Prague.

The donor gives his marrow for free. However, its examination, collection of cells abroad and transport to the Czech Republic cost the insurance company up to half a million crowns for a patient in need of marrow. It does not apply to purchases in the country.

Costs related to testing and selection are paid directly by centers establishing national donor registries from sponsorship donations.

For example, Česká průmyslova zdravotno pojišťovna paid for 30 bone marrow transplants from abroad last year, which together with all care cost almost 11.2 million crowns. The Home Ministry’s health insurance agency paid about 15 million for bone marrow to 50 clients last year.

Appropriate tissue can be found in most home patients with leukemia. The success rate reaches 80 percent. But it is a game with time and it is necessary to secure the donor at the right time. The disease progresses rapidly. A greater involvement of sex increases the chances of a faster transplant.

“If the recipient has unique, rare replacement characteristics, it’s very difficult to find a donor. The more donors you have, the better you can choose,” Jindra said.

Former Minister of Health John Blatney, a pediatric hematologist at Brno National University Hospital, sees it the same way. “The logistics of transplanting from abroad are more complicated than within a country, but they are standardized and work well. However, this does not mean that there are enough donors and that every recipient will find their donor in time.”

Transport from Australia, USA or UK is structurally more complex. Everything should be planned so that the tissues are with the patient within 48 hours or maximum three days. “Most of the donors are from Germany or Poland, where the ambulance goes with trained people. If it’s too far, we send a person with a cooling bag by air, it can be done,” emphasized Kurikova, head of the center of IKEM. “Until now, it has not happened to us that we did not bring what we had in order,” he pointed out.

The Czech registry has more than 150,000 donors. Due to aging, several hundred people die every year. Healthy people under 40 years of age and under 35 years of age in Pilsen can apply.

In international comparison, the Czech Republic is not bad. France, for example, has a much bigger problem. Bone marrow from French donors reaches less than seven percent of fellows. Austrians make up more than 11 percent of their patients.

The neighborhood with Germany benefits the Czech Republic because it has one of the world’s three largest donor registers – the others being the US and China – but mainly because of genetic proximity. Of the 41 million donors worldwide, whites have the best chance of finding a match. There is a problem with minorities such as Vietnamese, Hispanics or Roma. “Minorities have a different mix of tissue characters, so it’s difficult to find them. The problem is children from mixed marriages, it’s difficult to find a donor for them. They struggle mainly in America,” Prime Minister Jindra explained.

This is also a problem in the Czech Republic. Health conditions and chronic diseases are a barrier as representatives of minorities are not interested in donating.

Doctors transplanted 180 bone marrows from unrelated donors in the Czech Republic last year. Needle sampling from the spinal cord is no longer performed. The cells are taken through an infusion from a vein, where doctors wash them out. Adding to the database does not mean instant subscription. This happens years later, when the necessary patient appears, or never at all.