"The donor simply lies on a bed and watches a video for four hours while the machine takes the blood out and spins it in a centrifuge,".... "Stem cells are removed - because they separate on the basis of their weight - and then the rest of the blood comes back. For the donor, it's now an easy procedure, comparatively."
BY ANDREA WOO, VANCOUVER SUN
It began with a lack of appetite. Usually a big eater, in early fall Peter Dart began eating less than he normally did, sometimes telling his family that his stomach didn't feel right.
"I don't feel like eating tonight," he would tell his wife, Bonnie. "Maybe I'll just have a grilled cheese."
Then there was the fatigue. The Delta dad had been napping more, but Bonnie and their two sons, Joe, 19, and Ryan, 25, figured it was perhaps just part of the aging process for the retired marine engineer.
"We thought, 'He's 57 now, maybe he's just tired because of that,' " Bonnie said.
Then there was the sweating. On a late September trip to the family cabin near Greeny Lake, in B.C.'s interior, Peter sweated more than normal - but then again, he was chopping wood and hauling around heavy beams while performing repairs on the cabin.
But as the days passed, symptoms mounted: stomach swelling, vomiting, profuse sweating .
Peter was diagnosed on Oct. 7 with acute mast cell leukemia. He was transferred the same day to Vancouver General Hospital, where doctors immediately began chemotherapy.
Leukemia, a cancer of the blood, begins in the bone marrow with the growth of an abnormal stem cell, explained Dr. John Shepherd, director of the Leukemia/Bone Marrow Transplant program of B.C. The abnormal cells eventually suppress the growth of healthy cells.
Immediate and aggressive treatment is crucial. Left untreated, leukemia can be fatal.
"We have known for many years that while chemotherapy can cure some patients, stem-cell transplant, or bone-mar-row transplant, can cure more," Shepherd said.
While the optimal treatment of years past was bone marrow transplant - often painful for the donor - doctors today opt for peripheral blood stem cell transplantation.
"The donor simply lies on a bed and watches a video for four hours while the machine takes the blood out and spins it in a centrifuge," he said. "Stem cells are removed - because they separate on the basis of their weight - and then the rest of the blood comes back. For the donor, it's now an easy procedure, comparatively."
Perhaps the most challenging part is finding a match. The preferred donor is a matched sibling, but smaller families today mean a patient's chance of being matched with a brother or sister is only about 25 per cent, Shepherd said.
Patients then turn to unrelated donor registries, which comprise roughly 15 million people worldwide. The problem, however, is the vast majority of them are of white, northern European extractions.
"Your genetic type, your immune type - which is what is important for stem-cell trans-plant - follows your ethnic group," Shepherd explained. "For an individual who is of anything other than straight for-ward Anglo-Saxon Caucasian, the chance of finding a donor in the registry is dramatically lower, because those groups are under-represented."
Caucasians make up about 92 per cent of registrants and have about an 80 per cent chance of finding a stem-cell match, according to 2010 statistics. Doctors told Dart that his chance of finding a donor in the registry is "medium."
In comparison, ethnic Chinese have only about a five to 10 per cent chance of finding a match. Shepherd said this is the most under-represented group that he deals with.
For Preston Dong, this is particularly disheartening news. Diagnosed Oct. 25 with acute myeloid leukemia, the 39-year-old Richmond dad is also in need of a stem-cell transplant and recognizes finding a match will be difficult. Two siblings failed to match, and other family and friends have registered, so far with no success.
"Once you find out it's a cancer of the blood, and then you start looking into survival rates, it's like, 'Holy crap,' " Dong said.
Dong had two rounds of chemotherapy and is now in remission. He says the leukemia has not yet affected him physically, but a compromised immune system and lack of general health has kept him indoors - a drastic change from the active, outdoor lifestyle the assistant hockey coach is used to.
Dong and his wife, Sonja, have told their two children - Kurtis, eight, and Hayley, 11 - "as much as we possibly could, with the exception of survival rates and the future," he said.
"We're shielding them from that, a bit, because they don't need to hear that their dad is going to die."
Both Dart and Dong have undergone several rounds of chemotherapy and are now in remission.
On Dec. 11, Peter and Bonnie celebrated their 30th wedding anniversary in hospital.
"He cried because he couldn't give me anything," Bonnie said tearfully.
Both Dong and Dart are awaiting matching potential donors.
"We need to get more donors in the system," Dong said. "It's not an invasive process. The initial step, the mouth swab, is simple to do, and literally, you could save a person's life.
"And ... when it comes time to harvesting the stem cells it's not much more invasive than giving blood."
Canada's national database of potential stem-cell donors is 77 per cent Caucasian, according to Canadian Blood Services' OneMatch Stem Cell and Mar-row Network program. Among the remaining ethnicities, 5.2 per cent are Chinese, 3.6 per cent South Asian, 0.7 per cent black and 0.9 per cent aboriginal. About seven per cent are multi-ethnic.
Dr. Shepherd has heard from Chinese patients that cultural beliefs and ancient perspectives about the body often prevent them from donating, but such views appear to be changing.
Last year, the number of Chinese-Canadians registered as potential stem-cell donors grew 75 per cent after a donor drive by OneMatch in Vancouver and Toronto.
OneMatch, in partnership with OtherHalf Chinese Stem Cell Initiative, will host another drive at Richmond's Aberdeen Centre on Jan. 21. For more information visit www.onematch.ca.
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