Matched Unrelated Donor (MUD): An Emerging
need for Peripheral Blood Stem Cell Transplant
Vikash C Mishra*
Chimera Translational Research Fraternity Pvt. Ltd, India
Submission: November 15, 2018 Published: November 28, 2018
*Corresponding author: Vikash C Mishra, Chimera Translational Research Fraternity Pvt. Ltd, New Delhi, India
How to cite this article: Vikash C Mishra. Matched Unrelated Donor (MUD): An Emerging need for Peripheral Blood Stem Cell Transplant. JOJ Case
Stud. 2018; 9(2): 555759. DOI: 10.19080/JOJCS.2018.09.555759.
Blood is a vital component of human body which is involved in many functions most importantly supplying oxygen along with essential nutrients to various parts of body to maintain the growth. It also acts as excretory mediator as it helps in elimination of waste by product. Blood is made up of four components commonly known as Red Blood Cells (RBC), plasma, platelets and White Blood Cells (WBC). Each component plays its important role to maintain the regulations in the human body. In case if there is any malfunctioning in either of these components, this leads to blood disorders. Common types of Blood Related Disorders (BRD) are Acute Lymphoblastic Leukemia (ALL), Acute Myelogenous Leukemia (AML), Chronic Lymphocytic Leukemia (CLL), Chronic Myelogenous Leukemia (CML), Hodgkin Lymphoma (HL), Non-Hodgkin Lymphoma (NHL), Severe Aplastic Anemia (SAA), Sickle cell disease (SCD) and Thalassemia.
An approved therapy for blood cancers and other BRDs. Peripheral Blood stem cell (PBSC) can be defined as seeds which are capable of producing the new blood components. They are mainly synthesized in bone marrow. Basic requirements for PBSCT are availability of a donor, who can donate his or her stem cells to the needy patients. Donor can be related (knows as “Matched Related Donor”, MRD) and unrelated (known as “Matched Unrelated Donor”, MUD). The chances of finding suitable MRD is only 25% (siblings and other family members), but for remaining 75% patients there is need of MUD who is suitable for donation which will be you, me and any healthy individual above 18 years of age. Realizing the importance of MUD, many countries across the globe have initiated to recruit people voluntarily who give their informed consent to donate their hematopoietic stem cells (HSC) in order to help patients suffering from BRDs and blood cancer. There are 75 stem cell registries worldwide with more than 32 million registered. Unfortunately, in India, a country with population over 120 million however, representing less than 0.25 million donors.
A healthy individual above 18 years of age who has given informed consent for donation and is Human Leukocyte Antigen (HLA) matched. In simple words, immunologically compatible
with the patients. HLA is responsible for regulation of an
individual immune system and it has power to discriminate
between self and non-self.
There are 75 stem registries across globe. Voluntary matched
unrelated stem cell donor recruitment drives are conducted
to spread awareness among the people and motivate them to
register as a MUD. Once the donors have given their consent,
sample is taken, and high-resolution HLA typing has done, and
result is uploaded in World Marrow Donor Association (WMDA),
an international repository of worldwide donors.
VSCDR have HLA data of donors who are willing to donate
their hematopoietic stem cells to BRD patients. There are 4
stem cell registries in India (Genebandhu, Datri, MDRI and TTK)
working on building up large donor data pool. The search for
patient is done by matching the HLA data of patients and donor
and if they get matched then proceeds for transplant.
India is the second most populated country in the world with
population over 120 million and has been subjected to different
waves of immigration. With 22 official languages, India has
mixture of various ethnicities, cultures, languages, marriages
within communities which have resulted in unique gene pool. The
chances of finding donor for a patient within his own community
are more. But unfortunately, Indian donor represents less than
0.25 million out of 32 million donors resulting in very a smaller
number of chances to finding a donor.
Thus, to conclude, there is a need of enhanced awareness
among people about Peripheral Blood Stem cell (PBSC) donation
to build a larger pool of MUD and educate them about how this
process will benefit their own society and specially the patients
of India by making the transplant affordable and accessible. If
the MUD pool increases the chance of finding MUD within India
also increases which not only reduces the cost of the PBSCT but
also making treatment more accessible to patient across India.
To increase the number of MUD an initiative must be taken to
educate people on PBSC donation and spreading awareness,
the VSCDR to have a dedicated staff and counselor in order to
explain and educate about the concept in simple language. If
people get aware that they can save someone’s life by donating
their stem cell.