More than 1,000 people withdraw from the bone marrow database every month after reaching the age of 55, with fewer than 500 new entrants. The declining birthrate impacts the matching opportunities

More than a thousand people over the age of 55 leave the database every month, and fewer than 500 new members join the database.

The declining birthrate has impacted bone marrow donation, and the donor database is facing pressure as the number of new entrants cannot keep up with overage withdrawals. Yesterday, Ye Shipeng, chairman of the Blood and Marrow Transplantation Society of the Republic of China, warned that there are currently about 480,000 to 490,000 entries in the Tzu Chi bone marrow database. Since this year, an average of about 1,000 filers per month have reached the age of 55 and must withdraw. However, there are almost less than 500 new entrants per month, which is less than half of the past. If "more outgoing and less incoming" continues, it may affect the chances of patients with leukemia and other cancers to find a suitable match.

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Decreasing birthrate: patients have fewer brothers and sisters

Ye Shi-peng said that Taiwan currently has 24 bone marrow transplant centers, which completed more than 980 cases last year and are expected to exceed 1,000 cases this year, of which about 55% are allogeneic transplants. However, the declining birthrate has reduced the number of brothers and sisters, making it more difficult for patients to find compatible donors from relatives. The chance of a complete match between non-relatives is only about one in 100,000.

Ye Shipeng said that in the past, about 1,000 new people were added to the database every month, which was roughly balanced with the number of over-age exits. However, this year, the number of new people added every month is almost less than 500, showing "more outgoing and less incoming".

The younger you are, the healthier your hematopoietic stem cells are.

Why can’t you donate marrow after the age of 55? Ye Shipeng explained that hematopoietic stem cells will age with age and may accumulate genetic mutations. After transplantation, the hematopoietic system must be re-established in the recipient's body, so the quality of the cells is required. International trends also tend to choose younger donors. "The younger the better, because the cells are healthier." He called on people aged 18 to 46 to draw 10 CC of blood to establish a record.

Minister of Health and Welfare Shi Chongliang said that even if new treatments such as cell and gene therapy continue to develop, bone marrow transplantation is still an important treatment to save patients' lives. Although Taiwan has excellent medical teams, drugs and equipment, "it is difficult to cook without rice." Without a source of bone marrow, no matter how good the technology is, it cannot be used. He called on us to dispel the myth that marrow donation is "water from the keel."

Director of National Health Insurance Chen Liangyu said that starting from September 1 last year, taking peripheral hematopoietic stem cell transplant as an example, the national health insurance payment was increased from about 1,500 points to 15,000 points to reflect the professional investment of the front-line medical team.

Does not affect health. Marrow donors’ testimonials

Mr. Zhu, a bone marrow donor, donated marrow in 2003 to save the life of a stranger patient. After that, he devoted himself to volunteer work for more than 20 years, and his daughter also took the initiative to register when she became an adult. Mr. Chen completed the donation with peripheral blood, and later got married and had a son and a daughter, dispelling the myth that marrow donation affects fertility.

The bone marrow recipient, Mr. Liu, was diagnosed with acute myeloid leukemia at the age of 23. His only sister did not match the match. He waited for six months in the non-relative database to find a donor. He has now lived in good health for more than 16 years. Another 80-year-old Ms. Lin was diagnosed with acute myeloid leukemia in 2019. After receiving an allogeneic bone marrow transplant, she has lived in good health for more than seven years.