Japan has made great strides in the fight against leukemia in the last two decades that have seen bone marrow transplants increase, while the implementation of a nationwide donor program also has contributed significantly.
But the donor pool still needs to be expanded further to give more patients on the waiting list a chance of finding a marrow match, and a better shot at undergoing the life-saving surgery.
As of the end of 2011, about 400,000 potential donors were registered with the Japan Marrow Donor Program and around 13,700 patients in total had received bone marrow transplants since its inception in 1991. Approximately 34,600 patients have sought transplants since the program started.
But many patients still die before a suitable donor match is found, and the program is looking to expand the donor pool through raising public awareness about bone marrow donations. Undergoing a transplant in time can eradicate the cancer, which attacks the body’s blood-forming tissues, including bone marrow and the lymphatic system.
“I wish more people would join the program and that all patients could be given the chance to survive,” said former leukemia patient Chikako Kimura, 39, who had one of the early bone marrow transplants during the program’s first years.
Kimura was diagnosed with acute myelogenous leukemia in 1991, a year after graduating from high school and starting to work. That spring, she felt constantly tired but shrugged it off as resulting from the rigors of her job.
That December, however, Kimura saw a doctor about swelling in her legs. She was immediately hospitalized and started to receive treatment, but didn’t learn she had leukemia until several years later.
Kimura was not informed she had leukemia until spring 1993, when her doctor told her a donor with bone marrow matching her type had been found and encouraged to her to undergo a transplant. A year earlier, the doctor had put her on the waiting list of the fledgling bone marrow donor program.
Initially, she balked at the proposal as her condition had been stabilized through chemotherapy. But she eventually decided to take a chance.
“I was really lucky to find a matching donor so soon, given the small pool of donors at the time,” Kimura recalled.
According to the foundation that set up the program, more than 527,000 people have registered as potential bone marrow donors since January 1992.
The donor pool swelled after a TV campaign was launched in July 2005 featuring Masami Ihara, a former captain of Japan’s national soccer team, who appealed for more people to register. The high-profile campaign helped raise public awareness over the issue and led to a flood of inquiries to the four toll-free numbers the foundation set up.
“From the first day (of the TV ads), we had our hands full answering phone calls” from the public asking how to become donors, said Hidehiko Okubo of the foundation.
The TV campaign was later amended to use the images of actress Masako Natsume, who died of leukemia in 1985, and singer Minako Honda, who died in 2005.
The easing of criteria that must be met before being allowed to register as a donor and an increase in locations nationwide where people can register also helped to boost donor numbers.
The donor pool has now expanded to a level where more than 90 percent of leukemia patients on the waiting list can expect to find at least one suitable match.
But even if they find a potential donor, logistical or other reasons currently prevent about 40 percent of leukemia patients from actually receiving transplants. And it remains extremely difficult to find donors for some patients with rare white blood cell types.
The foundation’s Okubo said trying to cure leukemia only by bone marrow transplants has its limits, and noted another kind of transplant was granted the green light in October 2010.
The procedure, which uses hematopoietic stem cells extracted from the blood of healthy people, had until 2010 only been allowed in Japan for transplants involving family members.
While 33 medical facilities are capable of performing such transplants, only two leukemia patients have been operated on so far.
The new procedure is expected to increase the number of people willing to become donors, as it involves fewer health risks than bone marrow transplants.
More than 18 years on from her transplant, Kimura now works as a nurse. “Many people have supported me. I wanted to be of some help to other people,” she explained.