HKU Bulletin April 2006 (Vol. 7 No. 2)

15 A Perfect Match I mmunologist Brian Hawkins has long been linked with bone marrow matching, an association that has had a serendipitous beginning and end for him. In 1991 when he was wondering how to encourage local people to become marrow donors, a little boy showed up on his doorstep and galvanised thousands to sign up. And last year, as he began preparations to retire from the University and his work on bone marrow appeals, the Red Cross stepped in to provide a stable home for his cause. Hawkins will retire from the University in May after 24 years and his success with the Marrow Match Foundation, now called the Hong Kong Bone Marrow Donor Registry, is his crowning achievement. Hundreds of lives have been saved because of his untiring, voluntary efforts. “I’m very pleased that the Red Cross is taking over. It shouldn’t be necessary for something as important as this to be funded solely by donations of $200 from this person or $500 from that person. It should have the backing of a large organisation behind it,” he said. For years, however, bone marrow donations relied on the dedication and energy of Hawkins and his helpers. Hawkins arrived in 1982 to set up a tissue-typing laboratory for kidney transplants, a programme that was soon running successfully thanks in large part to Hong Kong people’s willingness to donate kidneys to family members. By the end of the decade facilities had been developed for bone marrow transplants, but the donor situation was far more complicated. An exact match is needed, unlike kidney transplants, and often cannot be found within the family. For people stricken with such diseases as Leukaemia, a transplant from a stranger is often their main hope of survival. Yet there was poor acceptance and understanding about bone marrow donations in the community, a situation aggravated by the fact that bone marrow sounds like spinal cord in Cantonese. “It occurred to me that what we needed in Hong Kong was a register of Chinese tissue types. The difficulty is there are thousands and thousands of different tissue types and you need thousands on your registry for it to be useful for individual patients,” he said. Then in 1991 Gordon Wu showed up, a sweet-faced two- year-old in desperate need of a donor. The family came from Canada, where most of the donors were Caucasians and therefore not compatible, genetically, with Chinese recipients. His father contacted movie actor and director John Sham for help, who together with Hawkins and the newly formed Marrow Match Foundation organised a bone marrow drive at the Convention Centre. Hawkins was overwhelmed by the response. In two days some 10,000 people signed up in the hope their bone marrow matched Gordon’s. Many others gave money. Gordon became the first ‘index’ patient to focus public attention on bone marrow donation. “Gordon did not find a donor. As life sometimes turns out, his disease went into spontaneous remission and he didn’t need a transplant. This is extremely rare. He came to visit us a couple of years ago and he’s strong and healthy,” Hawkins said. Hawkins’ work since then has been to carry forward the goodwill generated by Gordon’s case. Since 1991 well over 250 people have received bone marrow donations arranged by the registry, including more than 40 abroad. The registry now has more than 45,000 names on its list, which was handed over to the Red Cross after potential donors were contacted by the Foundation. That does not mean everyone who needs bone marrow finds a donor. Some people will not find a donor in the region and some of those will have to deal with the heartbreak that they cannot afford to look further afield for a match. In the US, which has the world’s largest registry, it costs a minimum $200,000 to get bone marrow. “I really feel for people who know there is the possibility of going outside to find a marrow match but can’t do it because their financial situation won’t permit it. One of the good things in Hong Kong is that there is a system available that will allow them to get treatment irrespective of their financial circumstances,” he said. Hawkins had his name on the donor list until 10 years ago when he had a health problem and has great respect for those who have donated. They often have to overcome objections from parents and grandparents and endure some pain and a general anaesthetic when donating their bone marrow. “When people donate bone marrow it demonstrates their generosity and humanity, they are doing something for their fellow man. If I had bone marrow that could be of use to anyone, I would certainly donate it,” he said. From May, however, potential donors will have to contact Hawkins in Malaysia where he will retire. He hopes to maintain some connection with tissue typing and bone marrow drives if his help is needed. In the meantime he looks forward to a future that will make it easier for patients to find matches. “Currently about 50 per cent of Hong Kong patients find a donor. I hope in five years to see 75 per cent or more finding donors because China is expanding its registry,” Hawkins said. “Even more encouraging, within a decade the need for donors could be less as a number of therapies are coming on the market that could negate the need for transplants,” he added. 14 PEOPLE