Doctors say a Toronto man has shown no signs of his HIV infection since receiving a bone marrow transplant. If he stays virus-free through 2
A Toronto man could soon join a small club of people in the world considered cured of HIV following a bone marrow transplant to treat cancer that left the immunodeficiency virus in remission.
The 62-year-old man, identified by the health officials only as the “Toronto patient,” had developed acute myelogenous leukemia in 2021 and underwent a bone marrow transplant at University Health Network’s Princess Margaret Cancer Centre.
The procedure involved donor stem cells that were selected because they contained a rare genetic mutation called “delta-32.”
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whoag u said anyome can ask abt ur bone marrow donation, so here goes… first of all I fidn’t even KNOW you could DO that. Crazy stuff. Second… did it hurt? It hurt, right? I can’t imagine is NOT hurting. Oh lord. Also, how often can one donate bone marrow? Anyway hope ur doing good, this is really cool good for you congrats(idk what to say here uh) 👍👍👍👍👍👍👍👍👍
Of course! My pleasure!!!
Donating bone marrow is really funky because bone marrow is what makes your immune system! Blood is made in The Bones, which feels wrong, but it's true. This includes your white blood cells and all of the other components that help you fight off infection. In individuals with blood cancers, often times their bone marrow IS the problem- it's creating mutated/cancerous blood cells.
So, your bone marrow is broken and producing cells that will kill you. And in response, humanity invented the most metal answer to this ever: nuking your bones until they're marrowless. And then taking someone else's bone marrow and swapping it in.
So basically, I just gave someone an entirely new immune system. Which is fucking awesome.
Answering your other questions beneath the cut so this doesn't get too long on everyone's dashboard!
The thing about bone marrow though is that it's really specific person-to-person; if the genetic markers in the bone marrow aren't an exact match, the bones will reject any attempt to swap out bone marrow.
Most people in the United States only have 2-3 people who are a genetic match for their bone marrow. Only 30% of people will have a match within their immediate family. Most patients find their match through a donor that isn't related to them! That was the case for my patient.
In college, inspired by a certain episode of the show Knight Rider (which was about bone marrow donation!), I joined the National Marrow Donor Project, otherwise known as NMDP or "Be the Match". NMDP is the organization that keeps the genetic database of all potential donors in the U.S., so that if a patient needs a bone marrow transplant, they can find a match! Joining the database registry is as simple as sending in a cheek swab by mail to NMDP. Furthermore, only 1% of people on the registry ever get the call that they're a match.
NMDP reached out to me in February to confirm that I was the match for a patient in need. After that, they walked me through the process of getting ready for a donation. There was a lot of lab testing- I had to do multiple blood draws and do a quick physical check-up to make sure I was in good health to do the donation. After that, NMDP paid for my airfare to the nearest apheresis hospital (more on what that is later), my hotel, and all my meals during the donation process. They also paid the way for a companion of my choice to join me and be there with me during the process.
To finally get around to answering your second question- yes, the process did hurt. There's two methods of donating bone marrow:
The method everyone thinks of, which is a surgery where you go under anesthesia and they pull bone marrow directly from your bones
The newer method, called Peripheral Blood Stem Cell (or PBSC)!
I underwent PBSC. To explain it in simple terms- doctors injected me with a medication that made my bones overproduce bone marrow! After five days of these injections, doctors are then able to hook me up to a special machine to take the extra bone marrow out of my blood and put it in a bag to then be put into my receiving patient. That's actually the bag I'm holding in my photo- that's all the extra bone marrow filtered out of my blood!
But because your bones are working overtime, it makes your bones hurt! Any current or former reddit users might get a chuckle out of this- they literally gave me the "bone hurting juice". It made my hips, my back, my ribs, and my skull ache. It wasn't pleasant. It felt a lot like cramping, and it gave me a gnarly headache, especially on days 4 and 5. But my personal NMDP coordinator walked me through how to keep myself healthy and as comfortable as possible, helping me with pain management, diet, etc. They were super helpful and made the process much more bearable.
As for the donation period itself- I showed up to the hospital, they laid me down in a bed, used an ultrasound to find the large veins in my arms, and put in two needles, one in each arm. These needles connected to the machine that my blood ran through to filter out my bone marrow. I know this sounds scary, but it really wasn't. If anything, this part was the most relaxing part of the whole process. I had a nurse who kept me warm and comfortable and I was in a quiet room with the lights dimmed. I honestly napped through the process. That sounds like bullshit, but I swear I'm telling you the truth.
Afterwards, I felt a little weak, but I was certainly moving on my own. The only pain I felt was the residual symptoms of the bone-hurting medication. This day was the worst day of the migraine for me, but the hotel that NMDP booked was super nice, so I could just rest for the day. The next day I flew home, and was already feeling much much better.
So that was my process! Sorry it turned into a bit of a long dump lol.
To answer your last question- most people only ever donate bone marrow once in their lives. It's possible I could make a second donation, but only if my matched patient needs an extra boost to their immune system if my first donation doesn't take hold as well as it should.
From the patient side of things, the whole process is much more harrowing. In the leadup to receiving my bone marrow, my patient will have had to undergo some of the most intense chemo/radiation therapy there is, in order to literally kill off all of their old faulty bone marrow. Then they have to stay in a perfectly sterile room, as they're without an immune system until they receive my replacement bone marrow.
I don't get to meet my patient until a year has passed. It's a safety thing on my patient's end- they need to make sure their new immune system is working properly -and to make sure we're both in the right headspace for such a meeting.
I hope my patient is doing okay. I hope that my immune system treats them well. Regardless of how it goes, I'm giving my patient a new chance at life, whereas before they were almost certainly going to die.
Thank you so much for asking about it. I hope that my story might inspire some of you to sign up for NMDP's donor registry. Every new person means a potential match for someone diagnosed with a blood cancer. I'd do this process again in a heartbeat.
