Medical student Matthew Blango was on campus at Indiana University School of Medicine—Bloomington when he encountered some students at a table wanting a bit of his DNA. It wouldn’t take long, just a simple cheek swab. But it could mean the “gift of life” for someone with blood cancer.
Blango’s sample would travel to a lab where DNA would be extracted from the cells to determine his unique profile of human leukocyte antigens, or HLA type — the biomarkers important for bone marrow transplantation. That information would then be entered into a national registry of potential donors.
“I thought it’s something easy I could do,” recalled Blango. “They said at some point in the future, you’ll maybe hear from us, or maybe not.”
Two years later, he got that call. In June, Blango traveled to Tampa, Florida, where he underwent surgery to draw out liquid marrow from his hip bone. He was later told his healthy blood stem cells were successfully transplanted into an adult patient with leukemia, someone he’d never met and perhaps never will.
“I think about them and hope for the best outcome each day,” Blango said.
Every three minutes, someone in the U.S. is diagnosed with a blood cancer. Only 25% of those who need a bone marrow or stem cell transplant will be able to find a suitable donor in their family. That’s where the National Marrow Donor Program, known as NMDP, comes in.
Blango was swabbed at a collection event hosted by Gift of Life at Indiana University. Over the years, the group has swabbed almost 18,000 people, resulting in about 800 potential matches and 49 transplants. Collection events on college campuses are vital, said Jennifer Schwartz, MD, because when it comes to donating blood stem cells, “the youth have it.” Research shows that transplant outcomes are best when donors are in the 18-31 age range, although donors beyond that age are used.
As a young Black man, Blango fell into one of the most needed donor demographics. Donors and recipients are usually from similar ancestry, including ethnic and racial backgrounds, since factors influencing a successful transplant are inherited.
“The Black population is definitely underrepresented on the registry,” said Schwartz, professor of clinical medicine in the Division of Hematology/Oncology at the IU School of Medicine and interim director of the IU Health Adult Blood and Bone Marrow Transplant and Cellular Therapy program. “I encourage everyone, especially people from underrepresented communities, to get swabbed.”
With research advances, donors no longer need to be a “perfect match,” she added.
“I think what Matthew has done is incredible, and it’s because of people like him that my patients have a chance at life,” Schwartz said. “It’s a selfless act — literally the gift of life. It gives people that chance to have long-term survival.”
Why is bone marrow donation needed?
Approximately every three minutes, one person in the United States is diagnosed with blood cancer. About 20,000 Americans will need a marrow transplant every year, and one in every 200 Americans will have a transplant involving blood stem cells within their lifetime, according to the Gift of Life Marrow Registry.
More than 75 diseases can be cured or significantly improved by a transplant of the hematopoietic, or blood-forming, stem cells found in marrow. Those include blood cancers like leukemia and lymphoma, inherited blood disorders like sickle cell disease, and other inherited anemias, immune system disorders and metabolic disorders.
“This is giving patients who have inferior prognoses hope,” said Schwartz, who is a member of the IU Simon Comprehensive Cancer Center.
Blango said he was surprised when, two years after that initial cheek swab, he was notified he had “matched.” After two, hour-long phone calls and a comprehensive physical exam involving a chest X-ray, an EKG and about 18 vials of blood, the match was confirmed.
“I got the green light to be able to go through with it,” Blango said. “Honestly, I was excited to be able to do this for someone else. I don’t think I was ever really scared. They provided reassurance that they’re making sure everything is safe for you and safe for the other person and just walked me through the whole process.”
How does bone marrow donation work?
Lifesaving hematopoietic stem cells can be harvested in two ways: surgically from bone marrow or through a non-surgical, outpatient procedure called peripheral blood stem cell donation. PBSC is the most common method, used in 90% of cases. Preparation for that procedure involves five days of daily injections to stimulate the mobilization of stem cells from the bone marrow space into the circulating blood. The donor then sits for about six hours at a donation center undergoing apheresis, which involves drawing blood from one arm, extracting only the hematopoietic cells, and then returning the remaining blood components to the other arm.
The choice to do PBSC or marrow donation depends on multiple factors, including the patient’s underlying condition as well as potential factors on the donor’s end. Due to a medical risk identified during Blango’s screening, he was not a candidate for PBSC donation. He underwent the surgical procedure in which liquid marrow is collected directly from the back of the pelvic bone. The recovery involved a week or so of tenderness and lower back pain.
Blango counts his discomfort as minor compared to the illness endured by the person on the receiving end of his bone marrow — the human life he is hoping his donation will save.
“To me, I felt like I wasn’t the one who was doing a whole lot,” he said. “I’m just a piece of the puzzle to help someone else be able to live their life.”
The hardest part for Blango, as a busy medical student, was working out the logistics of traveling to Florida for the donation. Thankfully, the patient’s timeline aligned with a break in his schedule. Blango was encouraged to bring a support person with him, and since his family lives in another state, Blango chose a medical school classmate, Kamal Singh. They got to “talk a little bit of shop” with the stem cell transplant physician and enjoyed learning about his path into the field.
“I am interested in physical medicine and rehabilitation and sports medicine, so recovering from surgeries interests me,” said Blango, who is now entering his final year of medical school.
As he sat in the waiting room for his pre-op appointment, Blango chatted with others who were there to receive transplants. They talked a bit about their illnesses, but a lot more about their families, jobs and lives outside of the treatment room.
“As a physician, we’re just part of the equation of trying to help people get better,” he said. “Being present and maintaining their dignity as a person, talking about their life, I think that goes a long way in terms of their recovery, remembering they’re more than just whatever they’re going through at the time.”
Where can you learn more about bone marrow donation?
Blango has agreed to be a contact for potential bone marrow donors via NMDP. He’s happy to share about his experience and let others know what they can expect if they match.
“I would highly recommend that if you’re healthy and you have the privilege of being able to donate, it is something you should heavily consider doing,” Blango said.
Anyone interested in becoming a donor can find out more or join the registry through the NMDP website. Free, mail-in swab kits are available.
“If you’re going to get swabbed, you are doing this for the good of humanity,” Schwartz said. “We absolutely need more donors. You may not get called, but then again, you may be that one match.”
