The recruitment of stem cell donors began in the 1990s
Marja-Kaisa Auvinen worked as a doctor at the Bone Marrow Donor Registry (currently, the Stem Cell Registry) from 1992–1996. Today, she works as Head of Section of Clinical Immunology and Transfusion Medicine in Uppsala in Sweden, but she can still remember the early years at the registry.
"I joined the Blood Service as a young pharmacy student for a summer job back in the 1980s. When I became a medical student a couple of years later, I started working as a night-time officer conducting blood group research and deliveries at night. Sometimes we had to call in donors in the middle of the night.
In 1992, when the Bone Marrow Donor Registry was established, I was asked to run it. I accepted the offer with excitement. In the beginning, we had our laboratory methods, a computer system, and, as I recall, 40 donors.
This was all new, even to us, because until that time, stem cells in Finland had only been transferred between siblings. The development of DNA-based tissue-typing methods meant that we could finally start to look for suitable donors from larger groups.
Donor recruitment went well from the start. Blood donors were a natural and appropriate target group and we also travelled around the country talking to conscripts and students about the registry and bone marrow donation in general. We also created quite a lot of publicity".
"Our target was to sign up 10,000 donors in the registry within five years, but we achieved this target in four years. People were very interested and genuinely wanted to help. Stem cell transplantation played a key role in the treatment of childhood leukaemia, for example, for which the survival rates increased rapidly. Heavy cancer treatment always requires the support of a stem cell transplantation.
The first donations were nerve-racking, as there was no routine. Today, stem cells are mainly collected from the bloodstream, but back then, the cells were collected from bone marrow. People were afraid of paralysis, because they thought that the cells were collected from the spinal cord, which does sound similar. We quickly rectified these misunderstandings.
I remember when the first donors arrived in Helsinki. We were so nervous that we went to meet them at the airport to make sure that everything went according to plan. I think we might have even given them some chocolates. The stem cells were collected in the Meilahti hospital and the patient may have been at the same hospital, or at the Children's Hospital".
Memories of courier services
"From the beginning, the registry handled all practical matters from travel arrangements to compensation for loss of earnings. We assured the hospitals that we would have the donor in the right place at the right time. It was also important to arrange insurance cover for the donors and make sure that an independent doctor carried out a thorough physical examination before the donation.
Soon, we also began arranging transplants for other countries and receiving them from abroad. A doctor would always collect transplants from abroad. I have many enjoyable memories of these courier trips. On one occasion, I had great difficulty finding the consulting doctor at a hospital. The porter was frantically searching for "Doctor Luidin", until it occurred to me that they had copied the word "luuydin" (bone marrow) from my papers, rather than the name of the actual doctor.
In general, international cooperation was close. In the early days of the registry, we found a transplant in America, but we didn't have the accreditation required by the US authorities. They had accreditation in Stockholm, so we flew the patient there to receive the transplant. Once the registry was running smoothly, I moved to Sweden to specialise in clinical immunology and transfusion medicine. This was not possible in Finland.
All in all, we managed to get the Bone Marrow Donor Registry – the current Stem Cell Registry – running very smoothly. It quickly became one of the key operations of the Blood Service".
Text: Minna Kalajoki / Mediafocus
Photos: Matti Rajala