Finding a bone marrow donor from outside the patient's family is more difficult than looking for a needle in a haystack. But Monika Sankowska does it successfully. It has just been 10 years since she performed the first bone marrow transplant from an unrelated person in Poland
Medigen clinic in the Bemowo estate in Warsaw. I am greeted by an elegant blonde. Monika Sankowska has been conducting research onantigenstransplantation for several years. He selects donors unrelated tobone marrow transplants . Together with the microbiologist Leszek Kauc, she created the Anti-Leukemia Foundation and a register ofbone marrow donors , which she runs socially.
Are you a microbiologist?
- I graduated from the Medical University of Lodz, Faculty of Medical Analytics. Then I got a job at the Institute of Hematology in Warsaw.
People in the world were already doing transplants from unrelated donors?
- Yes, but the methods for selecting such a donor were very imperfect. Even with family transplants, there have been mistakes. Now we have antigen determination tests ready, they were not there yet. For several years, I was involved in the development of methods that looked for points of convergence between the donor and recipient.
With what effect?
- I have developed the DNA Finger Printing method, which consists in comparing the finger's stripes. Thanks to her, I found a family donor for a sick man.
How did you find the first unrelated donor?
- The same method that I later abandoned, because new ones appeared. On the wave of my first success, I persuaded professor Hołowiecki from the Clinic of Transplantology in Katowice to try. He said that if I found the right donor and recipient, he would take a risk. I found and in 1997 the first such transplant was performed.
You chose Urszula Jaworska, why exactly her?
- Mrs. Jaworska had an antigen very common to our population, so it was possible to find many donors for her and choose the best one, which turned out to be a Dutchman.
After this success, you left the Institute. Why?
- There was no money for such transplants and I was transferred to another project. They took away the topic that I had devoted several years tolife, so I left to work on my own. Fortunately, I met Leszek, who invited me to cooperate, and I could continue to do the same.
How do you search for donors?
- There are many unrelated donor registries in the world. They began to appear at the turn of the 1980s and 1990s in England on the initiative of the families of sick people. Today, around 10 million people wanting to donate bone marrow are registered worldwide. All registers, including Polish ones, are in the world database.
How many registers are there in Poland?
- Currently five. I created four of them myself - the first at the request of Mrs. Jaworska and her foundation. Our register - the Foundation Against Leukemia - is the smallest, but the youngest in the world, because many young people have come to us. We also have the best results in Poland: thanks to him, the most marrow was donated.
Errors occur frequently?
- Unfortunately, yes, and you have to remember that a mistake usually costs a human life. These are highly specialized procedures that should not be done by every center. Speed and accuracy count. Recently a boy has been treated with chemotherapy for 5 years. Research excluded a family donor. Something was wrong for me, so I repeated the tests. It turned out that earlier someone had made a mistake in typing and the boy's mom was marked as non-compliant, and in fact may be a donor. Who will give this child 5 years of chemo and slow dying?
How to find a donor?
- The patient who has been qualified for transplantation is sent to the Transplantology Clinic. If there is no family donor for him, the clinic, and sometimes the patient himself, decides where to look for an unrelated donor. We, like other institutions, enter the competition every year and receive money from the ministry to search for donors.
How many donors have you been able to find since 1997?
- Over 400 people have had transplants from donors I have indicated. This year it will be around half a thousand.
Finding a donor is like a detective investigation?
- This is a puzzle. Everyone is different. But while no two people are alike, there can be significant similarities. The point is to track these similarities. I am like a hunting dog on a trail.
Nothing can hide from you?
- Nothing. I know immediately who is from where. Recently, I discovered Tatar roots in one patient. When she talked to her father, it turned out that she did. Poles are a genetic mix and it makes no sense to say that donors for Poles should only be found in Polish registers. You have to look smart! Therefore, when, for example, I need a donor forLithuanian, I look through the registers in Western Pomerania, because many people there come from the East.
There are people who are completely unique?
- Yes. Our colleague hematologist reported to the donor registry and after a blood test it turned out that he is the only one in the world. This inspired him so much that he finally found some Eskimo tribe from which he could descend.
Are you registered in your register?
- Of course! And I also have a fairly rare pattern of genes. My mother comes from the family of General Bem. An old family, but with a rare genotype.
Do you have personal contact with patients?
- This is necessary. Talking to patients and their families is part of my job. I provide them not only with information, but also with mental support.
And do you remember all of them?
- Yes … I even remember their gene patterns.
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