Johannesburg - There appears to be bad blood between two of the country’s biggest bone marrow operators, the SA Bone Marrow Registry (SABMR) and Deutsche Knochenmarkspenderdatei, DKMS, based in Germany but operating in SA.
The SAMBR cautioned other registries operating in South Africa against outsourcing donor searchers to international centralised hubs outside of the country saying it could lead to local expertise being lost. Bone marrow registries recruit, register and search for stem cell transplants, which are an important life-saving treatment for many South African patients.
Deputy Director of the SABMR, Jane Ward said contracting out donor searches to overseas countries was bound to erode essential skills in a highly specialised medical field, which need to be retained locally.
“Conducting donor searches within our own country is important for database security, proximity, compatibility, availability and capacity building. Keeping the skills within the country helps to build capacity and key competencies among the next generation of SA’s workforce. SA-based search coordinators also understand the language, geography, customs, and traditions of the country, which provide a much better patient service experience.”
Local search coordinators also have a firm grasp on the specific genes that are predominant among SA’s 60+ million population.
Ward added that haplotypes (a group of genetic markers in an organism that are inherited together from a single parent) play a crucial role in the process of matching potential bone marrow or stem cell donors with recipients.
“They provide information about the genetic diversity within populations. Donor search coordinators aim to find donors who have haplotypes similar to the patient's, particularly within their ethnic or racial group. This is because individuals from the same population are more likely to have similar haplotypes, increasing the chances of finding a suitable match,”she said.
Ward added that African populations are characterised by greater levels of genetic diversity compared to non-African populations, and the fact that they also possess a number of genetic adaptations that have evolved in response to diverse climates and diets, as well as exposure to pathogens and infectious disease, make it critical for South Africa to preserve its expertise in this field.
“The SABMR is the only World Marrow Donor Association (WMDA) accredited registry in Africa and has been in operation for more than 30 years. All of our search coordinators are required to have a degree or diploma in genetics or medical technology and must complete the WMDA Search Coordinator Certificate Programme. When patients and/or transplant centres choose the SABMR as their registry of choice, they help to keep the expertise within South Africa, which not only benefits patients, but creates a more skilled and diverse workforce that promotes the economic development and social well-being of our country,” she concluded.
But DKMS spokesperson, Julia Schmitz said their work helped patients in South Africa to find a matching stem cell donor and the DKMS Registry supported transplant centres in South Africa in their search for unrelated donors or cord blood units for their patients.
“To identify the best match, we search in both the DKMS and the worldwide donor pool of all international registries hosted by the World Marrow Donor Association, as a donor match could come from anywhere in the world. Worldwide, more than 11.5 million potential stem cell donors are registered with DKMS. In South Africa, more than 50 000 potential stem cell donors are registered with DKMS,” she said. She added that although a donor match could come from anywhere in the world, unique genetic information exists within different regions and countries worldwide.
“The likelihood of finding a genetic twin within one’s own ethnic group is greater than outside. DKMS has increased its international footprint to help patients in South Africa, and worldwide. In addition, DKMS launched a pilot programme in South Africa in 2022 in cooperation with Be The Match, USA, for young patients from South Africa suffering from blood cancer and life-threatening blood disorders,” Schmitz said.
She added that by fostering local expertise, making an impact and knowledge sharing, DKMS SA is not only creating jobs but also fostering the expertise of its employees in South Africa.
“Our team from DKMS Africa makes blood cancer visible through education and awareness. So far, DKMS Africa has recruited 58,874 donors, 13,809 of them in the first half year of 2023 alone. Further, we strongly believe in sharing knowledge and in the exchange of best practices with registries and transplant centres around the world,” Schmitz said.