- The 15th Mobilization Week for Bone Marrow Donation takes place from March 16 to 22.
- 20 Minutes interviewed Evelyne Marry, director of the bone marrow donor registry at the Biomedicine Agency
- She explains to us why France needs, as a priority, young donors and men.
How to convince young people to give a little of themselves? As the 15th Mobilization Week for Bone Marrow Donation starts this Monday, the Biomedicine Agency is launching an awareness campaign, with the aim of targeting young people and men…
The opportunity to take stock of the progress of this donation, which is too often confused with the donation of spinal cord, with Evelyne Marry, director of the register of bone marrow donors at the Biomedicine Agency.
What is the purpose of a bone marrow donation?
To help patients who have a serious blood disorder and who need a bone marrow change. To donate, you must be between the ages of 18 and 50, be in good health and be registered. The more donors registered, the more patients can be saved. Knowing that there is a one in a million chance of finding a compatible donor outside of his family. And that there are 73 registers in the world, all linked.
What profile are you looking for?
Young men. Our registry was created in 1986, and since we stay on the registry until the age of 60, the people who go out must be replaced by young people. We know that in the median, donors wait eight years to donate their bone marrow. So it is better to register at 25 than at 49… Another reason: the younger you are, the more numerous, active and efficient the bone marrow cells are. For patients, this is an additional chance.
Second criterion, gender. Only 35% of the French register is made up of men. However, women can have children, and from the moment you carry an embryo, you develop antibodies, which the body keeps in memory throughout life. However, these antibodies complicate the bone marrow transplant.
Are there other priority criteria?
We therefore want men under 35, but also from multiple [ethnic] origins. Because depending on the origin, there are different markers. In absolute terms, we can only give to someone who genetically resembles us. And in France, we are lucky to be a very diverse country at the genetic level.
How does the donation work?
There are two types of direct debits. In 80% of cases, it looks like a donation of platelets. In all of our bones, there is a very vascular, red marrow. It is a "maternity" which permanently manufactures stem cells. These give rise to red, white blood cells and platelets. Four or five days before the donation, a biomedicine is injected under the skin, which stimulates the bone marrow. Stem cells are thus created in number in the bones. To get out of this too confined environment, they will pass into the blood. For 3 or 4 hours, we will take the blood in a vein, sort the cells to make a graft, and the rest of the blood, red, white cells and plasma, are returned to the donor. We therefore do not strip it of its stock!
The other method of sampling consists in looking in the pelvic bone for these stem cells, which we are going to aspirate. This operation takes place under general anesthesia, because the bone is very painful. This marrow, with its environment, will be more suitable for certain recipients, especially for children.
But can we choose between these two very different direct debits?
No. We do not have a three-speed register: one for those who would donate by blood, another under general anesthesia, a third again for those who would agree for both.
How many transplants are performed each year?
About 2,000, half of which are intrafamily. Our goal is to increase the register of 20,000 additional donors each year [it has 300,000 registered]. In 2019, we exceeded our target: we registered 27,000 and we hope to continue on this dynamic.
Our survey shows that, on our young panel, 56% agree to donate a little marrow during their lifetime…
Last year, out of the 27,000 registered, 85% were young people. But only 34% of men. This is why the Biomedicine Agency's campaigns focus on raising awareness among young men. We must continue to play down, it is done safely, it is not painful. In any case, we will not take a risk to this donor. If in the meantime, he has developed pathologies, he leaves the register. And he can refuse the donation. Even if it is not what we are looking for, because by registering, you give hope to patients around the world.
And how do you register to register?
The dondemoelleosseuse.fr site provides good information. If you are sure of yourself, you can pre-register online by filling out a questionnaire. We verify that you are of age, that there are no contraindications. Afterwards, there is a first-hand appointment, with medical interview and sample. Which can be a blood test or a mouth sample, or even a saliva sample. The markers that we use to calculate the compatibility between donor and recipient are sent to the lab, which does HLA typing.
When the typing is done, the donor is informed by email that he is entered in the register, he is given his anonymity code. He can then be contacted at any time to make this donation. This community has been called the "life watchers".
Society
Bone marrow transplant: "It's strange, I feel like we're connected"
Health
"Repairing the living": When the cinema breaks the taboo on organ donation
- Health
- Bioethics law
- Youth
- Society
- Blood donation
- Organ donation