[HN Gopher] A new era of personalised medicine: or how I got mys...
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       A new era of personalised medicine: or how I got myself sequenced
       for free
        
       Author : souradip
       Score  : 49 points
       Date   : 2021-05-13 20:26 UTC (2 hours ago)
        
 (HTM) web link (souradip.mookerj.ee)
 (TXT) w3m dump (souradip.mookerj.ee)
        
       | kharak wrote:
       | I personally feel that this embodies the hacker spirit perfectly.
       | Has this service been intended to allow the donor access to his
       | sequencing data? No. Can someone use the systems in place to get
       | this info anyway? Yes, as it shows.
       | 
       | The other comments mind the burden to the charities. I personally
       | cannot agree here. After all, this is the donors data. One might
       | even think, that proactively sharing data could increase the
       | number of donors.
        
       | ineedasername wrote:
       | An importing distinction: The author did not get himself
       | sequenced. He had genotyping.
       | 
       | Genotyping basically picks out a few specific data points.
       | Sequencing reads an entire piece or entire genome completely.
       | 
       | From a health perspective, genotyping pulls data points that we
       | _already know_ can be markers for something significant.
       | Sequencing gets a lot more data, and would sort of be  "future
       | proof" against the need to do further testing if new markers were
       | identified you can just look at the data already gathered.
       | Otherwise you'd need to get Genotyping done again.
        
         | souradip wrote:
         | This is very true, and genotyping just the HLA/KIR loci won't
         | tell you much about all the other genes that are important for
         | health. However, the HLA typing is at least a start (and a free
         | byproduct of signing up to donate stem cells) to introduce you
         | to the rabbit hole of personal genomics! :)
         | 
         | This is also slightly different to the (linkage-disequilibrium-
         | based) SNP arraying done by other genotyping places, since the
         | HLA locus is fairly widely researched in its associations with
         | infection and (auto)immunity!
        
       | Zababa wrote:
       | Fun fact: getting a DNA sequencing is illegal in France and is
       | punishable by a 3750EUR fine. I find this frustrating that I
       | can't legally access my _own_ DNA.
        
         | smegger001 wrote:
         | Why would they make that a law? Please say there are
         | medical/research exemptions at least?
        
       | notahacker wrote:
       | I'm all in favour of signing up as a marrow donor (I'm registered
       | with DKNS myself) but burdening charities with administrative
       | tasks to save yourself money feels a bit... cheap, and you get a
       | _lot_ more for paying for a full genome sequencing or even a
       | 23andme report.
        
         | hellbannedguy wrote:
         | I don't know anything about those two charities. In the USA,
         | 501c3's are in many cases just businesses. Meaning--they aren't
         | sacred benevolent entities.
         | 
         | Waystar used to off a free look at a nonprofits 1040's. I
         | believe their are other that offer a free look at this public
         | information.
         | 
         | So many nonprofits are ridiculously overfunded. So many only
         | pay a livable salary to the key founders, usually an husband
         | and wife team.
         | 
         | One day, I want to put together a list of good nonprofits.
         | 
         | I once heard St. Jude Children's hospital has enough funding to
         | last for 20 years, including costs of new technology; if
         | donations were cut off today.
         | 
         | My point is be savvy with donations. There are very good
         | charities out there.
         | 
         | (True story. National parks have one spot in the park available
         | for first admendment speech. In Muir Woods National Monument it
         | was a couple of parking spots. For years this guy used to hand
         | out flyers to tourists who just got off buses.
         | 
         | He had some nonprofit that proposed to save Redwood trees. I
         | looked up the nonprofit, and couldn't find it. Every night he
         | would show up to the local watering hole with a 3" stack of
         | money he woukd count out. I imagine he was making 2-3k a day.
         | Why am I enclosing this? Because I'm tired of charities taking
         | advantage of certain people.)
        
         | souradip wrote:
         | I should probably say that my primary reason for signing up to
         | a stem cell donor registry is to actually be a donor! This data
         | is generated as a byproduct of signing up and is also quite
         | interesting on a personal level.
         | 
         | I was thinking that framing it in a way to also find out
         | interesting things about yourself might be a good way to
         | encourage people who might not have thought about it to sign up
         | for the first time, and this would be far more cost-effective
         | than a traditional in-person donor recruitment drive, but let
         | me know what you think!
        
       | [deleted]
        
       | cblconfederate wrote:
       | dont do this. you can sequence yourself from Dante labs (an
       | italian company IIRC) which will give you all the data of 30x
       | sequencing including the raw reads for like $200. The problem is
       | -- i don't know what to do with the data as i havent had the time
       | to do anything.
        
         | souradip wrote:
         | You can sequence yourself properly (and it's more information
         | that way), but this way you can get called upon to donate if
         | you're a match for someone somewhere in the world!
        
           | cblconfederate wrote:
           | shouldn't you be able to match yourself (at least partially)
           | by uploading your data somewhere?
        
             | toomuchtodo wrote:
             | Ideally, charities provide a mechanism to ingest genotyping
             | data from providers through an auth flow for those who have
             | previously been sequenced or don't want to burden the
             | charity (if a donor can afford it) with the sequencing
             | cost.
             | 
             | If one could "one click" share my genotyping from 23andme
             | (and any of their other customers could as well), I imagine
             | you'd see an uptake in coverage of the populace. The data
             | is already out there.
        
           | redis_mlc wrote:
           | > you can get called upon to donate
           | 
           | Dude, calm down.
           | 
           | Donating bone marrow is probably ok, but note that before
           | donating a kidney, understand that can affect your health and
           | life expectancy. That was not told to past donors, but it's a
           | thing. (As you get older, your organ function decreases from
           | 100% (or 200%) to less than 100%, so losing a kidney affects
           | older people.
           | 
           | In China, people in banned religions are "volunteered" for
           | double-lung and heart transplants, so it also matters what
           | country you're in. Their transplant science is based on 28
           | year-olds, so if you're several years younger or older, you
           | should be good unless you have a rare typing.
        
       | _Microft wrote:
       | Let me be blunt, costing charities time and money that they could
       | use for their actual mission of helping people to find a life-
       | saving match with a donor is a real shitty move. This is
       | freeloading at its finest.
        
         | ineedasername wrote:
         | Yeah, kind of like "how I got my food for free" and the
         | punchline is you went to a local food bank.
         | 
         | If you're really that interested it getting it done for the
         | sake of curiosity the you can pay a variety of services about
         | $200 for it.
        
           | souradip wrote:
           | I like to think that using this analogy, here you're going to
           | the food bank and donating food (or your stem cells) while
           | getting data on how many people liked it in return.
           | 
           | I've seen too many kids with blood cancer who couldn't get a
           | match, so please do consider signing up to your local charity
           | :)
        
         | souradip wrote:
         | Hiya, author here! I wrote the article to mostly encourage
         | others to sign up to these charities to help accomplish their
         | mission, the data generated as a by-product is just a cool
         | side-effect!
        
           | toomuchtodo wrote:
           | It'd be fine if the charity made it an option to donate an
           | additional amount if you wanted your sequence provided to
           | you, to cover their cost to fulfill the request (negating the
           | need to fulfill a GDPR request). Otherwise, it's just poor
           | form and not to be emulated.
           | 
           | Because one can does not necessarily mean one should.
        
             | souradip wrote:
             | I do, and I donate to these charities because it's a cause
             | quite close to my heart.
             | 
             | At present it's clearly not scalable to be sending GDPR
             | requests one person at a time. I think perhaps if this kind
             | of incentive brings more people to sign up than traditional
             | donor recruitment drives (which is often much more than
             | handling a request for data!) then these charities will
             | provide easier, more scalable ways to access this data :)
        
               | [deleted]
        
         | blacksmith_tb wrote:
         | I wonder if charities couldn't offer it as an incentive to
         | attract more potential donors? Agree to participate, and we'll
         | give you your sequence upfront, no data-release-requests
         | needed? Obviously some people are trying hard not to be
         | sequenced for any reason (because of privacy concerns
         | apparently) but plenty of other people are interested in
         | heredity, or health implications.
        
           | ineedasername wrote:
           | I'm assuming the charities get a better rate, but typical
           | home kits cost about $200... Not cheap to give out for free
           | even if they get a 75% bulk discount. They're also not likely
           | to get money from people like this who were deliberately
           | working the system to avoid paying.
           | 
           | Not only that, but insurance will often cover services like
           | GeneSight that do this specifically as a health service.
        
             | blacksmith_tb wrote:
             | Sure, though here in the US I would bet most insurers would
             | require a physician to order the test for it to be covered?
             | Which presumably would happen only if they thought it'd be
             | useful for diagnosing something, rather than that you were
             | curious (esp. if your curiosity was about your heritage and
             | not something clearly medical).
        
               | toomuchtodo wrote:
               | While I'm unsure if insurance will cover sequencing of
               | the general public, the medical portion is covered as an
               | eligible FSA/HSA expense. We paid for our 23andme
               | genotyping with an FSA card, and 23andme provides a
               | letter and receipt from their website for reimbursement
               | if necessary.
        
       | amluto wrote:
       | I feel like GDPR-ing a bone marrow registry to obtain one's data
       | is rude. I got my HLA data from the registry by asking politely.
        
         | renewiltord wrote:
         | GDPR SARs are just a standardized form for a data subject to
         | have access to data on herself.
         | 
         | It is, in my opinion, far politer to use a form letter Subject
         | Access Request that can be dealt with using a standard process
         | rather than a custom interaction.
         | 
         | I see it as just picking things off a menu. Far less trouble
         | than describing to your waitress that you're looking for a
         | ground beef patty, grilled with cheese, with onions, tomatoes,
         | and lettuce added and placed between two buns.
         | 
         | Just say cheeseburger. You know cheeseburger. They know
         | cheeseburger. Everyone is better off.
        
       | iandanforth wrote:
       | "You may be aware of bone marrow, or stem cell transplants. These
       | are life-saving for the people who need them, especially after a
       | blood cancer. You can sign up for free at charities such as
       | Anthony Nolan or DKMS in the UK."
       | 
       | "And it was a win-win scenario - they get to call upon me if
       | someone needs my stem cells (a painless procedure that's no more
       | complicated than donating blood)!"
       | 
       | Maybe I'm confused but this person doesn't seem to know what is
       | involved with donating bone marrow. It is a serious surgical
       | procedure done under anesthesia.
       | 
       | https://bethematch.org/support-the-cause/donate-bone-marrow/...
        
         | shkkmo wrote:
         | The there are two procedures, the stem cell procedure is
         | acurately described according to the link you posted.
         | 
         | > How are bone marrow and peripheral blood stem cell (PBSC)
         | donation different?
         | 
         | > Donating bone marrow is a surgical procedure done under
         | general or regional anesthesia in a hospital. While a donor
         | receives anesthesia, doctors use needles to withdraw liquid
         | marrow from the back of the pelvic bone.
         | 
         | > PBSC donation is a non-surgical procedure done in an
         | outpatient clinic. PBSC donors receive daily injections of a
         | drug called filgrastim for five days, to increase the number of
         | blood-forming cells in the bloodstream. Then, through a process
         | called apheresis, a donor's blood is removed through a needle
         | in one arm and passed through a machine that separates out the
         | blood-forming cells. The remaining blood is returned to the
         | donor through the other arm.
        
           | iandanforth wrote:
           | Ahh that's what's going on, the first sentence conflates the
           | two and the second sentence doesn't specify PBSC.
        
             | [deleted]
        
         | renewiltord wrote:
         | Easy mistake to make since the first part lists two different
         | things. However, the listed orgs are both blood stem cell
         | donation charities.
        
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       (page generated 2021-05-13 23:00 UTC)