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everything you need to know to help little Joseph and the 2,000 patients awaiting a transplant

The call for bone marrow donation to save little Joseph, 3 years old, suffering from leukemia has moved all of France. What to do if you want to register as a donor in Lorraine? Is it painful? Little practical guide for all volunteers!

Each of us can save a life by donating our bone marrow, this is the message launched by the parents of little Joseph, 3 years old, suffering from leukemia. The little boy, who despite himself has become the standard-bearer of this cause, is awaiting a transplant, like 2,000 people in France. But how to do it ? Is it complicated? Sore ? Paid or free? Anonymous ?

We asked all these questions to Mickael Peres, Biological Pharmacist at the University Hospital of Nancy, responsible for voluntary bone marrow donors in Nancy.

Bone marrow transplantation is one of the only existing treatments for curing leukemia (blood cancer), which is difficult to treat with chemotherapy. But the bone marrow transplant is also used in the case of other genetic diseases of the immune system such as sickle cell disease or in the case of metabolic abnormalities or profound immune deficiencies (“bubble children”).

The transplant allows in most cases a definitive cure of the patients. In the case of the genetic diseases mentioned, the diseased cells are replaced by those of the donor. In the case of leukemia, it is the immune cells that will fight against the cancerous cells.

In all in France, 2000 people are waiting for a bone marrow transplant. The difficulty is to find a compatible donor. For Michael Peres, “the more people there are on the volunteer lists, the more chances there are for the sick”.

Men aged 18 to 35 are often mentioned, and rightly so.

Let’s start with gender. A man is physiologically often taller and heavier than a woman. The quantity of bone marrow taken from the donor must be equivalent to that of the recipient. A man of average build will therefore have a better chance of being able to donate enough stem cells to cure the patient.

And age in all this? The minimum required is 18 years old, only for legal reasons of consent. You have to be of age. Moreover, a donor will not be called immediately for a donation. You have to wait for your DNA to match that of a patient waiting for a transplant, and that takes time. The average time between registration on the lists of volunteers for donation and the call for collection is 8 to 10 years. Patients considered young, i.e. up to 35 years old, are therefore preferred to older ones.

The approach must be disinterested and totally altruistic because in France, the donation is not remunerated

Michael Peres, pharmacist-biologist at the University Hospital of Nancy

Namely: the donation is anonymous and for Mickael Peres, “the approach must be disinterested and totally altruistic because in France, the donation is not remunerated”. On the other hand, a work stoppage and all the costs incurred by the donation are covered. Moreover, we do not choose the receiver. We cannot therefore give for a specific person. Only DNA compatibility prevails. 50 global banks around the world work together. A French patient can therefore benefit from a transplant from Spain, Germany, Australia or the United States. Conversely, a donation made in France can go to the other side of the planet to save a life in the antipodes.

First step: go to the website and register. A questionnaire must then be completed.

To be permanently registered on the list of volunteers, two options are available to you:

* A medical interview on site in Nancy or Metz for Lorraine. A blood test will then be taken to determine your HLA (HLA antigens are markers of the immune system) and thus determine your compatibility with a patient.

* Another solution: Ask for a saliva kit that will allow you to take the sample yourself. Everything will be accompanied by a questionnaire to be completed at home.

At the end of this first step, after consent, you are registered on the list of voluntary donors. What follows requires agreeing to wait to be called back. And as said before, it can take time. Some volunteers are never called because they are not compatible with a patient awaiting a transplant.

Most of the time, a simple blood test will suffice to collect the stem cells needed to cure the patient. So it’s not painful.

Michael Peres, biologist at the University Hospital of Nancy

Second step: a patient awaiting a transplant is compatible with you. A certain number of checks will be carried out in your referral hospital (the closest to your home). For Michael Peres, “Most of the time, after these batteries of tests, a simple blood test will be enough to collect the stem cells necessary for the patient’s recovery. It is therefore not painful.” In other, rarer cases, a bone puncture may be recommended (always with your consent!). Under anesthesia, in the flat bones such as the pelvis, the sternum or the scapula, the doctors will take these “healing” stem cells. Again, zero pain.

You will then no longer be called, except for this same patient and only in case of urgent need. Finally, know that our body constantly renews our stem cells and our bone marrow. So you risk nothing, except saving a life…

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