Wanted: bone marrow donorI heard some very sad news recently from one of my best friends in Korea. Her mother has been diagnosed with acute lymphoblastic leukemia, a fast-spreading cancer of the white blood cells. She is in desperate need of a bone marrow transplant. In her case, this would very likely mean the difference between life and death.
Of course, she is on the list of patients waiting for a donor. There are more than 20 million registered potential donors in the world - so even though the chance of one individual being a match is in the tens of thousands to one, it would be natural to assume it an easy matter to find one for her.
Unfortunately though, she has not been so lucky yet.
Though a donor can come from anywhere in the world, the highest probability of finding a match comes from people of the same ethnicity. For my friend’s mother then, the best chance comes from Koreans, and then from donors in other East Asian countries.
It is also unfortunately true that for Asian patients, the overall probability of finding a match - other things being equal - is relatively low.
The chance of two random Caucasians being a match for each other is around 1 in 11,000. A study conducted in the United States showed the same figure for Asians as being 1 in 29,000.
Ideally then, Korea would have a donor registry with millions of names on it. Sadly though, the Korea Marrow Donor Program’s list was only 243,000-strong as of 2012.
This number is not growing quickly, either: the number of new registrants per year has been stuck between around 15-20,000 for a long time. Meanwhile, a number of existing registrants drops out each year, due to old age or death.
Per capita, there are countries with fewer registrants than Korea. But there are also countries with many, many more. The best example, Israel, has around 500,000 on its list. That is around 1 in every 16 Israelis. Germany has around four million; meaning 1 in 20.
My country, the United Kingdom, manages about 1 in 80. Korea though only has around 1 in 200 registered. Factoring in the reduced probability of finding matches (based on ethnicity), the situation faced by Korean patients is obviously much more desperate than that faced by Europeans.
Four out of five German patients will successfully find a donor. For Britons, that number is reduced to one in two. These numbers are directly related to the respective lengths of their countries’ registrant lists. Therefore, I assume the odds for Koreans to be much worse.
So how do we get more Koreans to sign up? First of all, the process here is initiated by going to a hospital and giving a blood sample. In other countries, there are cheek swab tests available, that can be done very simply and quickly, in any location. This latter method is obviously much more practical, so it would make sense to introduce cheek swab tests and “donor drives” here.
Unlike blood donation, bone marrow donation is a complicated and somewhat uncomfortable process that requires a few days off work.
Sadly, there is no legal provision guaranteeing a leave of absence for donors in Korea, and befitting the country with the longest working hours in the OECD, companies themselves are not going out of their way to encourage donation.
A bone marrow donor is quite literally saving another human being’s life, so surely the least society should do is make the process easier for them. I would also argue that a fund should be set up to provide meaningful compensation to donors.
Though anyone would naturally hope that any donor would act purely out of altruism, surely the end result is the main concern. And after all, the donor is put through several days of inconvenience, so it is surely reasonable to provide generous compensation for this.
According to doctors, the potential donor’s family also need to give consent. So while an individual may be happy to donate, his/her loved ones may derail the process.
It is natural to value a family member over total strangers, and also natural to have irrational fears when loved ones undergo any medical procedure. But bone marrow donation does not involve much risk, and I would argue that for the common good, the choice should be purely down to the individual.
If there were more names on Korea’s registry, more potential matches for my friend’s mother could be found.
And if potential donors were given time off work and better compensation, and were able to decide by themselves, perhaps the most heartbreaking thing of all would not have happened: Though three potential donors were identified, all of them eventually backed out of helping her.
Systemic reform is obviously needed, then. But in the meantime, it is entirely likely that one or two readers of this article would be able to save the life of my friend’s mother. Many more would be matches for one of the other patients waiting desperately for donors. So please consider doing a great thing today by signing up.
*The author is a former Seoul correspondent for The Economist.
by Daniel Tudor