Bone marrow, a gift still too little known

A face often marks more than great speeches. That of Joseph, 3 and a half years old, highlighted as rarely before the importance of bone marrow donation. On January 4, 2022, the little boy had just undergone more than eight hundred days of chemotherapy treatments when a blood test revealed a recurrence of his acute leukemia. “Perhaps it is you who will save our son’s life”, then write his parents in a call for help widely shared on social networks.

→ THE FACTS. Blood donation: equal access for homosexuals

“Their message sparked a remarkable outpouring of generosity”, welcomes Emmanuelle Cortot-Boucher, Director General of the Biomedicine Agency. In a few weeks, the public establishment receives several tens of thousands of requests for registration on the donor register.

A damaging confusion

Taking advantage of this unprecedented media coverage, the agency is launching an awareness campaign on this still little-known donation, often confused with that of the spinal cord. “Yet the two have nothing to do, insists Dr. Catherine Faucher, Assistant to the Department of Hematopoietic Stem Cell Sampling and Transplantation within the Biomedicine Agency. “Bone marrow makes the blood elements we need to live – white and red blood cells, platelets – and is found in the flat bones of the body, including the pelvis.The spinal cord is a nervous tissue located in the spine. »

A message that is still struggling to get through. “This confusion has been our ball and chain for years, because when we talk about the spinal cord, people are afraid of becoming paralyzed”, raises Catherine Faucher. No question here of touching the spine. In 80% of cases, the donation consists of a specific blood sample, which can last four to five hours. “The previous days, the donor must receive one to two daily injections of growth factor, in order to move the cells from the bone marrow into the blood”, she specifies.

40 million registered donors worldwide

Conditions to be a volunteer: be between 18 and 35 years old, transplants from younger people are more likely to take. To be in a good health. And ideally, be a man. “Women who have had a pregnancy, even an unsuccessful one, produce antibodies that can complicate the aftermath of the transplant”, explains Catherine Faucher.

When a transplant is indicated, a related donor is first sought among the siblings. “If there is no compatible donor, we look among the 330,000 people registered in the national register and finally among all the donors in the world”, continues the doctor. That is 40 million people spread over 73 registers, from India to Australia, from China to the United States.

The donor of Rebecca Ruimy, transplanted seventeen years ago, was German. And only 80% compatible. “With a 100% compatible donor, there is a one in two chance that the transplant will work, says this lawyer in her forties. The doctors were not very optimistic, and yet…”

“Grafting is a very cumbersome process, insists Catherine Faucher. In the case of malignant cancers, the outcome depends on many factors. But in the case of genetic diseases such as sickle cell anemia, a young transplant patient will come out of the hospital definitively cured, emphasizes the doctor. Imagine what that means for a child who has been sick since birth. It changes your life! »

Extreme variety of immune systems

Still, the chances of finding a compatible donor are very slim. In question, the extreme variety of immune systems. “There are thousands of different combinations, depending on geographical origins but also on the entire lineage that precedes us. Today, those registered are essentially of what we will call “European” origin. » The Agency is therefore currently seeking to recruit donors from diverse backgrounds in order to better meet demand. “It is essential that the registry reflects the diversity of the origins of the populations in order to improve the chances of finding a donor for each patient. »

“Children must be made aware of these subjects very early on”, says Rebecca Ruimy. A member of the Laurette-Fugain association, she regularly goes to schools to tell her story, to which she also devotes a show (1). “I don’t know my donor but there isn’t a day when I don’t think of him, she testifies. For me, he is my blood brother. »

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