École Polytechnique will host a donation clinic on Monday where young people can learn about this potentially life-saving process.
In August 2023, Raphaël Bots was a healthy, athletic 17-year-old about to start his second year of CEGEP. He was on the last leg of a European vacation with his family when, out of the blue, he started experiencing strange and, initially, mild symptoms.
“It started with a bit of lower back pain and some neck pain,” Bot told The Gazette. “I just thought I needed a good massage to relax. And then … there was fatigue. I was sleeping 18 hours a day and sweating a lot, even though we were blasting the AC in my room.”
After he returned home, the symptoms worsened. He noticed lumps on the back of his head and began to have trouble breathing, so his parents took him to the hospital.
A few days later, doctors would break the news Bots had a rare form of leukemia, a type of blood cancer, and without treatment he was days away from organ failure and possibly death. He would need months of chemotherapy, among other treatments.
But key to his survival would be a stem cell transplant. Because Bots is of mainly European descent, finding a compatible stem cell donor was relatively easy and it saved his life. Even though stem cell donation rates are abysmally low across Canada, particularly in Quebec, doctors were able to find several compatible donors through international stem cell registries.
Bots spent months in hospital and is still undergoing some treatment. He is not officially out of the woods, but is back in school and rebuilding his physical strength. And while his cancer experience has been harrowing, Bots realizes how lucky he was to have found a compatible donor.
“It’s all about awareness,” Bots said. “I didn’t realize it, but when I was getting my treatment … I was really lucky because my dad is European and my mom is a mix of European and Canadian, so I had multiple potential donors lined up who were a good match.”
Bots’s mother, Maud Cohen, happens to be the director of Montreal’s École Polytechnique, so when Duong approached her a few months ago to suggest a Swab the World clinic on campus to promote stem cell donation, Cohen jumped at the chance to help. The clinic will be on Monday, Oct. 28, from 11 a.m. to 3 p.m. at Polytechnique Montreal, 2700 chemin de la Tour, on the 6th floor of Pavillon Lassonde.
Cohen said the population of a university is the ideal recruitment pool because a good portion of the students and staff are between 18 and 35 years old, the optimal age for positive stem cell transplant results, studies show.
“Not only that, but we have a diverse population,” Cohen said. “Thirty per cent of our students come from international destinations and even among our Quebec-based students, there is a lot of diversity.”
The Swab the World website explains why ethnicity is important in stem cell transplants. “When it comes to finding a compatible stem cell donor match, doctors look at a part of your DNA called human leukocyte antigen (HLA) markers. Since these HLA markers are inherited, you’re much more likely to share the same combination of markers with people of the same ethnicity. The problem is that the majority of registered stem cell donors worldwide are white, even though most of the global population is not. This means that a person’s chance of finding a life-saving stem cell donor is heavily dependent on whether or not they’re white … and at Swab the World, we simply cannot accept this.”
Bots theorizes part of the problem with recruitment in Quebec may be rooted in language. In French, “greffe de moelle osseuse” suggests “bone graft,” which sounds like an involved or painful operation. In fact, medical advances are such most stem cell transplants are now mostly painless and not as invasive as surgery.
In a traditional bone marrow transplant, stem cells are collected from the liquid bone marrow of a donor, usually the pelvic bone, through a surgical procedure while the donor is under anesthetic. Those stem cells are then transferred to the person suffering from leukemia, lymphoma or other blood disorders and cancers.
Today, most stem cell transplants are done through peripheral blood stem cell donation, which is more like a blood transfusion. For five days before the procedure, donors are given injections of a hormone to stimulate their bone marrow to release stem cells into their bloodstream for several days before the procedure. Blood is then drawn from one arm, circulated into a machine that separates out the stem cells for the recipient, and the remaining blood is returned to the donor through the other arm. The process takes four to six hours and the donor may experience an achy feeling in the bones for a few days after the procedure.
Jean-Sébastien Delisle, a hematologist who performs stem cell transplants at Maisonneuve-Rosemont Hospital, explains the science.
“Our blood and immune systems all originate from the blood stem cells,” said Delisle, who teaches in the Université de Montréal’s medical faculty. “So when the stem cell is sick, when there is leukemia or other diseases of the blood or immune system … they need to be replaced. When conventional treatments do not work, we resort to stem cell transplantation. We change the entire system.”
This procedure eradicates the underlying disease and brings a new immune system online in the patient, he said.
“We prepare the patient with chemotherapy or radiation, and that will clean up most of the sick marrow. And we have to immune suppress the recipient so that the new graft is not rejected. We do that mostly with medication and chemotherapy, and then the new marrow settles in. So the new stem cells actually migrate to the bone marrow cavities and repopulate the blood system.”
The recipient also receives immune cells from the donor. These will recognize the cells of the recipient as foreign and will reject them.
“So the immune cells make room in a way, for the new marrow or the new stem cells to take. And on top of that, these immune cells can contribute to eradicating the residual cancer cells.”
You may never be called upon to donate, but if you are a match for someone, you could really be a hero, Cohen said. She urged parents to encourage their adult children to register.
“It’s easy and it could save a life. It could save your kid. Because it could be your kid. It happened to mine,” she said.
The clinic is open to everyone, not only Polytechnique students. Several of Bots’s friends will be attending to register as donors. Bots said he is touched by this.
“I am really happy they are doing it. I am proud of them for understanding,” he said.