Dr Catherine Flynn
Consultant Haematologist, National Bone Marrow Transplant Centre
Ireland has performed over 1,400 family and unrelated donor transplants. Blood cancers such as leukaemia, lymphoma and myeloma are why these have been performed.
Professor Shaun McCann’s supervised Ireland’s first bone marrow transplant in 1984, St James’s Hospital Dublin. Moreover, patients who have had a donor transplant include young adults. More recently, even patients up to 68 years old. Blood and cancer specialists all over Ireland refer patients to St James’ for transplant.
Susceptibility to blood cancers can increase with age but, with improved longevity in Ireland, (as highlighted in the recent TILDA project directed by Professor Kenny, TCD) older, fitter patients are seeking out this high risk – but potentially life-changing – procedure to cure their disease.
What is a transplant?
Allogeneic bone marrow transplantation involves transferring the stem cells from a healthy donor to a patient following chemotherapy or radiation. Usually a sibling or unrelated matching donor gives cells for harvesting.
Ireland requires more unrelated donors than ever before. This is due to decreasing family sizes and increased ethnic diversity. Close links between our National Adult Bone Marrow transplant centre and the Irish unrelated donor registry (IBMTR) are critical. This relationship helps find the best matched unrelated donors for Irish patients.
What are the symptoms of blood cancer?
When a patient presents with leukaemia or lymphoma, they will often have bleeding (nose bleeds, excessive bruising or internal bleeding), infection (repeated infections that fail to respond to antibiotics) or swollen lymph glands (in the neck, under the arms or hidden in the chest or abdomen).
Referrals to a specialist centres
Several diseases can have similar symptoms to these including viral illnesses such as glandular fever, HIV or other cancers and it is important to get medical advice to assist in making the correct diagnosis. Typically, an examination and blood tests will lead to referral to a specialist centre where additional scans and tests including a bone examination will make a definite diagnosis.
Technology is supporting patients after transplant
Technology is advancing to make diagnoses quicker and assess responses to initial treatment.
The most successful transplants happen when the disease is well controlled at the beginning of the procedure.
The advantage of a donor cell transplant is that, when successful, the patient has a new bone marrow and a new immune system. Many patients return to the workplace and family life and some pursue new adventures with their second chance.
All transplant survivors in St James’s hospital are invited to attend an annual medical review to optimise their long-term health. Looking after our increasing number of transplant survivors is a growing challenge.