“It started with swollen legs, and then it became swollen gums. Soon, it came to the point where I couldn’t eat or chew, and I felt tired all the time.”
Ever thought of becoming a bone marrow donor? Frankly, it wasn’t something that crossed my mind until I met Miranti Adriani. The 42-year-old Indonesian is a survivor of acute myeloid leukaemia – a rapidly progressing, deadly cancer of the blood and bone marrow. After a period of painful chemotherapy, it was a stranger in Singapore who saved her life. She sits down with me to share why we should consider registering as donors to help those struggling with blood-related diseases.
When life hinges on a bone marrow donor
When I popped on a Zoom call with Miranti in December, it struck me that she appeared so ordinary. You’d never guess she once brushed shoulders with death. She regales me with a play-by-play of her time with cancer in a cool, matter-of-fact way. But you can sense the fear that once reverberated through her body on the day she received her diagnosis in September 2014.
She was working in Indonesia when she began to feel ill. “It started with swollen legs, and then it became swollen gums,” Miranti shares. “At first, I brushed it off. But soon it came to the point where I couldn’t eat or chew, and I felt tired all the time.”
Her local doctors weren’t able to tell her what was wrong, so she made the trip to Singapore to seek help. It was here at the National University Hospital (NUH) that Miranti learnt she had acute myeloid leukaemia. Things progressed so quickly that up to 90% of the blood in her body contained cancer cells.
Naturally, this revelation was a blow to Miranti, who was just 34 at the time. For those older than 20, the five-year survival rate for such a diagnosis stands at just 27%. “I was miserable; I cried the whole day. I didn’t know if I would live, and the future felt so uncertain,” she says.
Thankfully, her wonderful doctors assured her she’d be well taken care of. They pointed her in the direction of the Bone Marrow Donor Programme (BMDP) – Singapore’s only register of volunteer bone marrow donors. Bone marrow transplants are commonly used to treat more than 60 potentially fatal diseases and several types of leukaemia. This meant that if Miranti could find a successful match, her chances for recovery would increase dramatically.
The road to recovery
At BMDP, Miranti provided a tissue sample through a buccal swab. This was compared against a list of donors to look out for matching proteins (or markers) called Human Leukocyte Antigens (HLA). Up to 12 HLA antigens are compared to ensure immunological compatibility, and doctors ideally look for a full match between patient and donor to prevent further health complications.
As she waited for a donor, Miranti recalls the painful journey of recovering from cancer. Her first round of treatment included seven days of chemotherapy, followed by three long weeks in the hospital.
“I had all the symptoms somebody would have from chemo, like nausea and lack of appetite. At the smell of food, I’d want to throw up,” she describes. Miranti also experienced mood swings, high fever, hair loss, and feeling weak all the time. “On top of that, I constantly worried about surviving.”
In these low months of her life, it was the care and concern of Miranti’s loved ones that helped her pull through. Her friends would come from Indonesia to visit, bringing letters, puzzles and books to keep her entertained. Her parents also put in substantial time, money and effort toward her recovery.
“My mother was by my side at all times. They both took note of all my food restrictions, and cooked or bought food for me to eat,” she says, noting that the burden of a caregiver is equally as heavy as that of the patient.
And then, a twist of fate! As luck would have it, Miranti received word just four months later in December 2014 that BMDP had found her a donor match. Well, almost…
Gratefulness to last a lifetime
“They told me the HLA antigens of the donor were not a full match, though it was still a good match for me,” Miranti shares. This meant there was a risk that the new white blood cells would attack her body. But she was willing to take it for a shot at a normal life free from chemotherapy.
In the same month, Miranti underwent the bone marrow transplant – a quick procedure that lasted just under an hour. What followed was another month of observation by doctors to ensure she was okay and that cancer cells were gradually reducing. Ultimately, her leap of faith paid off: Miranti exhibited zero signs of rejection, and was soon cured.
She even managed to meet her benefactor, under the facilitation of BMDP, and thanked him for saving her life. “It was a very emotional moment for me,” Miranti says. “I couldn’t thank him enough. If it wasn’t for him, I wouldn’t be here today.”
Her kind donor simply replied, “Looking at you today, I know all the effort was worth it.”
Registering as a bone marrow donor in Singapore
Eight years on, Miranti resides in Singapore and holds a job in a healthcare company. She’s returned to the humdrum of life – the days of fear, illness and pain behind her. But she occasionally thinks of those who are experiencing what she went through. Her reality, after all, differs from the many patients in Singapore who rely on BMDP for bone marrow donations.
In particular, minority groups like the Malay and Indian communities constitute only 8% and 9% of BMDP’s registry respectively. This means the chances of finding a perfect local match are staggeringly low for those struggling with blood-related diseases.
Miranti hopes more people will register themselves as bone marrow donors. “Imagine if this was happening to someone you love,” she says. “You can save somebody’s life. Isn’t that so rewarding?”
Her story reminds me that when we think of local heroes and lifesavers, we often conjure up images of brave doctors, firefighters or policemen. But perhaps looking out for each other should be a shared responsibility we carry. We can give someone a second chance at life – all it takes is a swab.
If you’re looking to register as a bone marrow donor, reach out to BMDP for more information.