TORONTO — For years, Stéphane Cliche was a healthy and active athlete, but he frequently experienced sinus and respiratory infections, leaving doctors puzzled about the underlying cause. It wasn't until he was diagnosed with non-Hodgkin lymphoma in 2016 that the issue with his immune system became apparent. Cliche needed immunoglobulin, a mixture of antibodies derived from donor blood plasma, as part of his treatment alongside chemotherapy, which often suppresses the immune system.
After completing his chemotherapy and immunoglobulin infusions, follow-up blood tests showed that Cliche had very few of his own antibodies. He would require regular immunoglobulin injections to function effectively, as the absence of a robust immune response made him vulnerable to infections. Now at 51 years old, the Ottawa college instructor credits the weekly infusions with enabling him to lead a normal, active life. According to Cliche, without immunoglobulin, it would be dangerous for him to interact with students as he would be susceptible to viruses and bacteria, resulting in repeated infections.
Cliche's experience is not unique; he is among thousands of Canadians who depend on immunoglobulin sourced from plasma. Canadian Blood Services reports that the demand for immunoglobulin is increasing each year. Currently, 70 percent of Canada’s supply is imported, primarily from the United States. Although there is no immediate shortage of immunoglobulin in Canada, the ongoing political inclination towards protectionism in the U.S. alongside a projection of about a 10 percent annual increase in demand poses a risk to the supply chain, according to Dr. Graham Sher, CEO of Canadian Blood Services.
Dr. Sher emphasizes the urgent need for Canada to enhance its domestic self-reliance in producing immunoglobulin. The rising demand is driven by factors such as an increase in cancer patients requiring antibody treatment during chemotherapy and a growing, aging population leading to more immune-related conditions, including autoimmune disorders. To meet this demand, it is essential to boost donation rates for plasma, which is the raw material required for immunoglobulin production. Currently, approximately 30 percent of the plasma needed comes from Canadian donors, which is then sent to facilities in the U.S. and Europe for manufacturing.
The strategic objective set forth by Canadian Blood Services is to achieve a minimum of 50 percent domestic self-reliance. This means that, at a minimum, half of the immunoglobulin utilized by Canadian patients will be collected from Canadian donors and manufactured within Canada. Dr. Sher notes that the goal is not to attain complete self-sufficiency but rather to maintain a diversified approach to avoid reliance on a single source.
To aid in achieving this self-reliance, Canadian Blood Services has partnered with Grifols, a biotechnology company based in Barcelona. Grifols is constructing a multi-phase facility in Montreal, which they purchased in 2020. The first phase, already operational, produces albumin, a protein found in plasma that aids in increasing blood volume. The plant's immunoglobulin production line is expected to be fully functional by the end of 2027. This partnership also includes price security measures to protect Canada from fluctuating global immunoglobulin prices.
A significant component of increasing Canada’s immunoglobulin supply is the need for more plasma donations. Dr. Sher highlights the urgency for more donors to come forward, as the current collection relies heavily on a small number of individuals. Although Canadian Blood Services plans to integrate whole blood and plasma donations at the same centers, many blood donor clinics are not yet equipped to process plasma donations. To address this, they have engaged Grifols to collect plasma at 17 designated centers across the country exclusively for Canadians, ensuring that all plasma collected is dedicated to domestic patients.
Donating plasma is analogous to whole blood donation, though it takes longer—around one hour compared to the 10 to 15 minutes required for blood donation. Both processes involve drawing blood through an IV, but during plasma donation, a machine separates the blood components, returning red and white blood cells to the donor. While individuals can donate whole blood every three months, plasma can be donated as frequently as once a week. Dr. Sher encourages donors to aim for six to eight plasma donations per year.
Individuals aged 17 years and older who are healthy, have not recently been pregnant, and do not have certain medical conditions may be eligible to donate plasma. Prospective donors must complete an online questionnaire from Canadian Blood Services, and there are waiting periods after receiving tattoos, piercings, or traveling to specific countries.
