Why donate bone marrow or blood stem cells?
You might choose to donate bone marrow or peripheral blood stem cells because you know someone who needs either for a transplant. For example, some people donate because a doctor thinks that person could be a match for a family member.
When you sign up to donate bone marrow or peripheral blood stem cells, you join a national registry of people who have agreed they're willing to donate bone marrow. Whether you receive a call to donate depends on whether you're ever a match for a person who needs your bone marrow.
There are more than 10,000 people each year diagnosed with some form of life-threatening disease, such as leukemia or aplastic anemia.
Chemotherapy and radiation are used to treat cancer to kill off cancer cells that divide quicker than most kinds of health cells. But this treatment can damage bone marrow because bone marrow cells divide frequently.
This is where the transplant comes in. Sometimes the only treatment option or the best option for these patients is a bone-marrow transplant or peripheral blood stem cell transplantation.
These patients must receive the transplant from someone who is a genetic match. This can prove difficult for patients of racial minorities. Usually, a patient will check with their family first to see if they can find a match. However, 70 percent of patients can't find a match within their families.
At any moment, there are a constant 6,000 patients who are looking for a bone marrow or blood stem cell donation.
If you are between 18 and 60, you might qualify to donate bone marrow.
What happens when you donate bone marrow?
The way that people donate bone marrow has changed over the years. There are two main methods used to help a disease patient restore his or her stem cells, which have been destroyed by chemotherapy or radiation therapy.
The more common method is peripheral blood stem cell collection. The other method involves taking marrow from a donor's pelvic bone. The recipient's doctor will choose which method is used.
Regardless of how you end up donating bone marrow, you must first register to donate bone marrow. During the registration process, a medical professional will swab your cheek to get your tissue type. You will fill out a form consenting to be placed on the bone marrow registry.
During the screening process, a medical professional will ask you various questions about your health. If you pass all the screening tests, you will be placed in the registry. You will be in this registry until you are 61, unless you request to be removed.
One out of 540 people in the registry in the U.S. will donate bone marrow or peripheral blood stem cells to a patient. If you're between 18 and 44, you are 10 times more likely to be a marrow donor than other registry members. That's because some research suggests 18- to 44-year-old donors lead to more successful transplants.
If you're selected to donate, you will come in for some blood testing and a physical exam. This is to determine if you're healthy enough to donate.
If you are chosen to donate through peripheral blood stem cell collection, about four or five days before you donate, you will be given a series of injections of medication known as filgrastim. That medication causes your bones to make more blood stem cells and for more stem cells to be present in your blood stream.
When you come into donate, a medical professional will place needles in both of your arms. A machine will filter out the blood stem cells from the rest of your blood and give the rest of your blood back. Your blood-forming cells should return to normal levels within four to six weeks.
The process is similar to blood donation but will take longer. It takes between four to six hours depending on your size and the need of donation. The process is sometimes split into two days depending on how long it will take. You must sit still and are not allowed to get up and move around.
Occasionally, when deemed it would produce a better outcome, a medical professional will draw marrow from your pelvic bone. This occurs with less than 25 percent of donors.
This is a surgical outpatient procedure performed in a hospital, different from peripheral blood stem cell collection, which is not a surgery. You will be given an anesthesia and shouldn't feel anything the doctor is doing during the procedure.
The doctor will use a needle to take liquid marrow from the back of your pelvic bone. Only 1 to 5 percent of your marrow is taken. The marrow should replace itself within four to six weeks.
Once your donation is complete, a courier takes it to the patient, who could be anywhere in the world. After a year, if the patient does well, you might have the chance to meet them.
Does it hurt?
Before you donate, your bones might feel achy. This is because the filgrastim is causing your bones to work harder to produce stem cells.
The needle sticks during the peripheral blood stem cell collection will hurt like any needle stick does. The process itself most likely will not hurt.
After the donation, you might have some bruising or soreness in your arms where the needles were inserted. Less than 1 percent of donors have anything more than fatigue afterward.
The process of donating bone marrow should not be painful, for you are given an anesthesia that should numb your lower body.
After the procedure, you likely will be sore on your lower back where the bone marrow was drawn. Some donors describe the soreness as similar to when you fall on your buttocks. Others say it feels like a strained back muscle. This ache will last anywhere from a few days to several weeks. Other side effects include fatigue, stiffness while walking and bleeding where the marrow was taken.
What are the risk factors?
As with taking any medication, there are potential risk factors to the filgrastim, including headache, nausea and vomiting.
All of these side effects should disappear within a few days after you stop taking filgrastim. Less than 1 percent of donors have an allergic reaction to filgrastim.
The risk factors related to peripheral blood stem cell collection are minimal. You might feel tingling in your mouth or fingers and maybe muscle cramps. This is generally caused from the blood thinner you might take for the procedure. This can sometimes be helped by slowing down the collection or by taking calcium. It is rare to see a decrease in blood platelet count or feel lightheaded.
With bone marrow donation, about 1 percent of donors experience serious issues related to the anesthesia or damage to the bone, nerve or muscle in their hip region.
What's the recovery time?
If you donate blood stem cells through needles in your arms, you should be able to return the work the next day. You might feel tired.
It's recommended to take it easy the next day and know your limits when it comes to strenuous physical activities, such as jogging, running or other vigorous exercise. You might also want to limit heavy lifting, depending on how you're feeling.
With bone marrow donation, the majority of donors report that they feel fully recovered within a few weeks.
What's the follow-up?
The place where you donate likely will call to check on you soon after you have donated. Also, the Oklahoma Blood Institute tracks you for the rest of your life once you donate, so once a year someone will contact you to see how you're doing.
Sources: Audrey Womack, Oklahoma Blood Institute marrow program coordinator; The Mayo Clinic; The National Marrow Donor Program; National Institutes of Health; The National Cancer Institute