Canada's blood supply has a diversity problem and people are dying because of it

Lauren Sano still wonders, if things were different, whether her father's life could have been saved. 

"You always wonder if there was someone in the registry who was a better match would have resulted in better outcomes and less transplant complications."

Mark Sano was a 52-year-old Toronto father of three. He worked in the financial industry as a marketing manager and in his spare time was an avid sportsman who loved tennis, hockey and especially skiing.

In November of 2019 he was diagnosed with a rare form of leukemia. The only thing that could save his life, doctors told his family, was a stem cell transplant; a critical treatment for blood cancers and dozens of other diseases.

According to Canadian Blood Services (CBS), stem cells are the body's basic building blocks – the raw material from which all cells are made. In blood, stem cells can become red, white blood cells or even blood platelets. 

"Without stem cells, the body cannot make the blood cells needed for the immune system to function," CBS says, which runs the national blood bank. 

It says a patient must find a match with a donor, and that is usually a person who shares the same ethnic background. 

CBS says right now, donors to Canada's blood stem cell registry are more than two-thirds Caucasian, with the other third fractured in uneven splinters across race and ethnicity. 

It means an Asian patient like Sano, according to the Canadian Blood Services stem cell registry, would have anywhere from seven to less than one per cent chance of finding a match, depending on his particular genetic background.

So when the Sano family sought a match, they found a lack of minority donors who were a close enough. Sano's daughter Lauren was the closest they could find and even then, she was far from ideal. 

"I ended up being a half-match for him and was his donor. It was the most fulfilling and grounding experience."

As fulfilling as it was, it wasn't enough. Sano died at Princess Margaret Hospital in October 2020, 18 months after he was first diagnosed.

Lauren still wonders, whether her dad's life could have been saved, had they found the right donor from a more racially diverse pool of donors. 

"I feel very lucky I was able to give him the gift of life. I was at least grateful that I was able to do this for my dad."

The dearth of diversity in Canada's stem cell registry is a problem Canadian Blood Services is familiar with, according to Heidi Elmoazzen, the agency's director of stem cells. She has been actively working on increasing the pool of minority donors to give minority patients a better shot at getting better. 

"We find that people tend to find matches within the same ethnic or racial background as them, which is why we're trying to build a registry that reflects the unique diversity we have here in Canada."

Some groups are more diverse than others when it comes to the make up of their stem cells, according to Elmoazzen. For example, she says Black people tend to be the most diverse.

A Black person whose ancestors are from the Caribbean might not have the same markers as someone from say, eastern Africa, which makes finding a match challenging. 

Age matters

Adding to the complication is that to harvest stem cells, you literally need young blood. Only young people, between the ages of 17 and 35 can apply. 

The ongoing COVID-19 pandemic has also disrupted recruitment efforts, Elmoazzen says. Canadian Blood Services finds 60 to 70 per cent of its potential stem cell donors during its community clinics and with everyone staying home, the number of people visiting is down. 

"It's had a heavy impact on our ability to recruit donors this year," she adds.

Still, virtual drives are underway. People interested in donating can still sign up through the Canadian Blood Services website.

There are also volunteers like Lauren Sano, who along with a number of Western University students will be pushing for donations in a virtual blood stem cell drive this month in honour of Black History Month and in April. 

The hope is that by reaching out to diverse communities, Sano says her goal is to help people make donating blood a habit. She says she hopes that will not only will boost the blood supply, but the supply of blood products, such as stem cells and platelets as well.