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Why are Canadians over 35 barred from signing up to donate bone marrow?

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Why are Canadians over 35 barred from signing up to donate bone marrow?


A few years ago, Yael Heffer wanted to get on the Canadian bone marrow donor list. But at age 36, she was already too old by standards set by Canadian Blood Services.

Heffer is already on the donor list in her home country of Israel, where the age limit is 50. Canada’s list had the same age limit until 2013, when the it was decreased to 35.

“I would like to donate if it could save a life,” said Heffer, now a graduate student in Vancouver.

‘Our transplant physicians have asked us to recruit younger, healthier donors’
Trudi Goels, Canadian Blood Services

“Being on the registry just seems like something that is a responsible thing to do as a citizen.”

Bone marrow donation, also known as blood stem cell donation, is often the last hope of survival for leukemia patients.Seven-year-old Joshua Weekes died earlier this week of acute myeloid leukemia after being unable to find a donor.

Joshua

Joshua’s Weekes is being remembered by friends, family and classmates for his kindness and big smile. (Weekes family)

Younger donors better for patients

CBS says the donation age was lowered because younger donors tend to offer better outcomes for patients.

“Our transplant physicians have asked us to recruit younger, healthier donors,” Goels said. “That’s how we make these decisions is based on what is best for the patients [according to] the people who treat them,” said CBS spokeswoman Trudi Goels.

Goels said patients who receive marrow donations from younger donors tend to have lower rates of graft versus host disease, where the donated cells are rejected by the patient’s body.

Goels said that, although donors need to be between 17 and 35 to get on the list, they remain on the list until age 60, though doctors will still prioritize younger donors.

Age limit higher internationally

The 2013 change means Canada has one of the lowest age cut-offs in the world for blood stem cell donation. Other countries such as Germany, Australia, the U.S. and the U.K. have age cut-offs between age 45 and 60.

But Goels says the change hasn`t reduced the pool of Canadian donors. She said more than 40,000 people registered last year, bringing the total number to just over 400,000.

Goels added that CBS’s network is linked to the marrow donation networks of other countries, meaning Canadians in need of marrow can still receive it from abroad if a match is found.

In order to be successful, the donor needs to share specific genetic similarities with the patient, but only about 25 per cent of patients find a compatible donor within their family. The rest need to rely on donors from the international network.

Goels said it can be hard to find compatible donors for patients of certain ethnic backgrounds with fewer donors registered, and it becomes significantly harder in cases of mixed ethnicity — as it was for Weekes, whose ethnic background was Icelandic, British, Filipino and West Indian.

Watch Joshua and his mother make a plea for donors1:19

Like saving ‘the whole world’

Heffer understands that there are medical reasons to prefer younger donors, and trusts that the medical community is doing what it believes is best for patients.

But she says she’d like to see more of a balance struck if it would mean more patients would be helped.

“I come from the Jewish tradition, and we say that if you save one life, it is as if you saved the whole world, or the whole of humanity,” Heffer said.

“It’s a thought that sticks with you.”

To register as a blood stem cell donor, visit the Canadian Blood Services website.



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