Improving the odds for blood, bone marrow transplants

As the Iowa Marrow Donor Program marks its 40th anniversary this year, those working to boost the registry of potential donors are focusing their efforts on reaching diverse populations to improve the chances that every patient receives a match.

The program, based at the University of Iowa Hospitals and Clinics, performed its first marrow transplant from an unrelated donor in 1981 — making it one of the oldest programs in the country. More than 900 Iowans have donated bone marrow or blood stem cells to strangers in the years since. However, program officials say there’s still more work to be done to help non-white patients.

“The goal is for every patient who needs unrelated transplant to have the same opportunity to find a match donor,” said Colleen Reardon, manager of the Iowa Marrow Donor Program. “Until registry looks like the United States, that’s not going to happen.”

For some advocates such as Diana Fonseca, that effort has become very personal. In recent years, Fonseca has encouraged dozens of people from her hometown of Marshalltown to register as a donor in honor of her older brother, Isaac Fonseca Garcia, who died in 2016 at 24.

He was diagnosed with acute myeloid leukemia in February 2016. It was then that Fonseca learned how difficult it can be for some Latino and individuals of color to find a donor for a bone marrow transplant.

“If I’m honest, it’s disappointing, but I understand it,” said Fonseca, 22. “You don’t really hear about someone needing a bone marrow transplant in the Hispanic population. It falls into our hands and not many people understand that.”

Blood cells and bone marrow donations are used to help patients with certain diseases, such as leukemia and lymphoma, create “a new blood-making factory,” Reardon said. There are two types of donations of blood-forming cells: peripheral blood cell donation and bone marrow donation.

It’s estimated only about 30 percent of patients have a matching donor among their siblings or close relatives — meaning the national registry of potential donors is critical. However, a patient’s likelihood of finding a matching unrelated donor through the registry varies depending on their ethnic background.

White patients have a 77 percent chance of matching with someone on the registry. But for Black patients, those odds drop to just 23 percent, according to Be the Match, a nonprofit that facilitates the transplants.

The odds are even worse for individuals who are multiracial or whose parents come from different ethnic backgrounds, Reardon said.

“If you mom is Chinese, and your dad is Irish and you need a transplant from someone in the general population, you have to someone who is half Chinese and half Irish,” Reardon said.

For a Hispanic or Latino patient, such as Isaac Fonseca, the odds of finding an unrelated match are 46 percent.

Isaac Fonseca Garcia did match with his sister, Martha Valdovinos, when he needed a bone marrow transplant in July 2016. Without a familial match, Diana Fonseca said she knew the chances of finding a match through the national registry were slim.

“I realized it was something that could have ended badly,” she said. “Had my sister not been around, we would have been in a hole.”

After receiving the bone marrow transplant, Fonseca Garcia was in remission by September. He died a short time later in December 2016 due to complications from pneumonia.

Fonseca, who graduated from Iowa State University this past May, continues to educate Marshalltown residents and encourage Latino residents to sign up for the donor registry in honor of her brother.

As part of the effort to diversify the potential donor pool, the Iowa Marrow Donor program is working with student-led Be the Match groups on the campuses of Iowa’s colleges and universities. They are working to recruit college-age individuals to the national registry by reaching out to campus cultural groups and strengthening their message on social media.

“The goal is to have therapies to cure everyone, no matter their ethnic background,” Reardon said. “That’s what we want.”

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