Cancer specialists are preparing to use cargo plane pilots instead of couriers to deliver life-saving stem cells to patients in need as global travel bans and border closings have created a “logistical nightmare” for the delivery of bone marrow and organ donations.
DKMS, an international bone marrow donor center based in Germany, which helps thousands of patients who need bone marrow and stem cell transplants find donors every year, said it has been scrambling to help at least 113 patients who are awaiting their stem cell transplants in the next two weeks. Dozens more are scheduled for transplants in the next 30 days.
In many cases, the patients have already begun a grueling treatment of high-dose chemotherapy and radiation to prepare for their transplants, and will need stem cells from donors to arrive on time.
The process of delivering the stem cells has been severely complicated by global travel bans, border closings and quarantine rules that force couriers into isolation for 14 days after they have returned from a high-risk area.
DKMS scored a major victory last weekend when its US partner, the National Marrow Donor Program, helped secure a travel waiver from the Centers for Disease Control that will allow couriers who are non-US citizens and non-residents to travel to the US to deliver stem cells collected from European donors.
But the group is still beset by other logistical issues and concerns, including questions about whether future planned donations will be hampered by flight cancellations and staffing issues in hospitals overwhelmed by Covid-19 patients.
Closed borders within Europe are also creating havoc, with DKMS pointing to one difficult recent case in which stem cells were collected from a donor in Poland, brought to Frankfurt, Germany, and then sent to the US. Travel bans in India and Israel are also a big problem.
“One of the problems we have right now is that there are less and less couriers and normal passenger flights will be reduced in the days and weeks,” said Elke Neujahr, the global chief executive of DKMS, who said the group is trying to recruit new couriers. “We think we will run out of regular commercial flights soon.”
One possible solution – which Neujahr said will probably be necessary beginning two weeks from now – will be for cargo plane pilots to personally carry the stem cells on their flights so that they can be delivered to medical professionals at airports, and then brought to hospitals.
Asked if she believed cargo pilots will be willing to help, since stem cells must be carried in-person, Neujahr said: “I think they will do it, because if they know they can save a life, their willingness will be very, very high.”
The problems facing DKMS and similar organizations show how the pandemic is affecting every aspect of medical care, including for the most vulnerable cancer patients.
While many hospitals are delaying non-emergency treatments and surgeries in the face of the pandemic, the aggressive nature of many blood cancers means that transplants cannot be delayed.
Marcel van den Brink, head of the hematological malignancies division at Memorial Sloan Kettering Cancer Center in New York and international chairman of DKMS, described several big challenges he faced last weekend, from tracking the movements of staff who have come into contact with patients who are positive for Covid-19, to planning for a possible drastic reduction in available doctors and other staff due to illness, which could require pulling doctors from other services to help treat Covid-19 patients.
“There is no doubt that cancer care is going to be compromised and Sophie’s Choice-like choices will have to be made. We are doing everything we can now … some folks are saying this might change medicine forever,” he said.
