BONE MARROW DONATION

Bone marrow is a spongy material found inside your bones. The bone marrow contains immature stem cells, which can develop into three different types of blood cells:

Red blood cells to carry oxygen to your body
Platelets to help your blood clot, when needed
White blood cells to help fight infection
It is the stem cells in your bone marrow that can benefit the transplant recipient.

In the past, donation of stem cells from bone marrow involved minor surgery to draw marrow from your hipbones. Stems cells were then collected from the donated marrow. Today the most common way of collecting the stem cells is by filtering them directly from your blood. Doctors call this procedure peripheral blood stem cell donation, but many people still refer to it as bone marrow donation, even though bone marrow isn't directly involved.

You may be able to donate your bone marrow stem cells if you're in good health and doctors determine that you're a match for the person who needs a bone marrow stem cell transplant.

Doctors compare the characteristics of the stem cells in your bone marrow to those of the potential recipient to see if the proteins in your cells are similar. A close match increases the chances that the recipient's body will accept your bone marrow cells. Doctors can test your stem cells by examining a small sample of your blood. Your full brothers and sisters are the best match for your bone marrow.

If your bone marrow appears to be a suitable match for the person waiting for a transplant, you'll undergo an examination to ensure that your bone marrow can be transplanted. The doctor will want to rule out any genetic or infectious diseases you might have, since these can be passed on to the bone marrow recipient. The doctor also asks questions about your general health and your family health history to determine whether bone marrow donation will be safe for you.

 How do you prepare for bone marrow stem cell donation?

Before you can donate your bone marrow, doctors give you injections of a medication to draw the blood stem cells out from your bone marrow and into your bloodstream. That way they can be easily filtered from your blood.

The medication, filgrastim (Neupogen), is typically given as an injection once a day for four or five days before your bone marrow stem cell donation. Doctors will monitor your blood counts to see how your body is reacting to the filgrastim. They'll also be looking to see if you have an optimal number of stem cells circulating in your blood.

 How is bone marrow stem cell donation done?

During bone marrow stem cell donation, a machine collects your blood stem cells through a process called apheresis. Blood is drawn from your arm and runs through a machine that filters out the blood stem cells. Then your blood is returned to your body through your opposite arm.

Apheresis takes four to six hours. You'll typically undergo two to four apheresis sessions, depending on how many blood stem cells are needed.

What can you expect during bone marrow stem cell donation?

Removing blood stem cells from your blood during apheresis doesn't hurt. However, the medication you're given to coax the blood stem cells out of your marrow may cause bone pain — similar to the aches you might feel if you have the flu. On rare occasions the pain may be so severe that you might discontinue the injections. The bone pain goes away once you stop receiving the injections. Other common side effects are fatigue, headache, muscle pain, and tingling around the lips, mouth and fingers.


Risks of bone marrow stem cell donation

Bone marrow stem cell donation is generally safe. Side effects associated with bone marrow stem cell donation include:

Bone pain
Headache
Muscle pain
Fatigue
Insomnia
Nausea and flu-like symptoms
Sweating
Loss of appetite
Tingling
These side effects go away once you complete the bone marrow stem cell donation. If you have small veins in your arms or you have veins with thin walls, your doctor may need to insert a catheter into larger veins in your body — including those in your groin and your neck. This occurs most commonly in small women. Placing a catheter in your larger veins rarely causes side effects, but complications can include:

Air trapped between your lungs and your chest wall (pneumothorax)
Bleeding
Infection


 Consider donating bone marrow stem cells to a stranger
Some people in need of a bone marrow stem cell transplant don't have any family members with compatible bone marrow. These people often turn to the National Marrow Donor Program to find a compatible donor. The donor program keeps a database of volunteers who are willing to donate their bone marrow to strangers.

Consider registering to be a donor so that you can help other people in need of a bone marrow stem cell transplant. Even if you weren't a match for your family member, you may be a match for a stranger. For more information on how to be a donor, contact the National Marrow Donor Program.

 If any of the following apply to you unfortunately you will be unable to join the bone marrow donation register.

You are aged under 16 or over 30.

You weigh under 8st (51kg) or are severely overweight (a BMI of more than 35).

You (or your partner) are, or think you are, HIV or Human T-cell lymphotropic virus (HTLV) positive or believe you may carry the Hepatitis B or C virus.

You don’t live in the UK.

You have ever been injected with non-prescription drugs including body-building drugs (includes one off use)

You are involved in high-risk sexual practices that may increase your exposure to sexually-transmitted diseases.

You have EVER had any of the following:
Cancer (including leukaemia)

Heart disease or heart surgery

Stroke

Epilepsy (unless you have not had a seizure or taken medication for epilepsy for the last three years)

Any neurological condition

COPD including lung clots

Diabetes (unless this is controlled by diet alone)

Ulcerative colitis or Crohn’s disease

Sarcoidosis

Reiter’s syndrome

Autoimmune conditions including rheumatoid arthritis

Systemic lupus erythematosus (SLE)

Ankylosing spondylitis

Vasculitis

Sickle cell disease

Graves’ disease

Hashimoto’s thyroiditis

Pernicious anaemia

Myasthenia gravis

Schizophrenia

Haemophilia

Thalassaemia

Sciatica

Hepatitis or a positive blood test for hepatitis or HTLV

An allergy to latex or anaesthetic
Special note
If you are pregnant you may join the register but will not be made active until your baby is one year old.


Consider donating bone marrow stem cells to a stranger
Some people in need of a bone marrow stem cell transplant don't have any family members with compatible bone marrow. These people often turn to the National Marrow Donor Program to find a compatible donor. The donor program keeps a database of volunteers who are willing to donate their bone marrow to strangers.

Consider registering to be a donor so that you can help other people in need of a bone marrow stem cell transplant. Even if you weren't a match for your family member, you may be a match for a stranger. For more information on how to be a donor, contact the National Marrow Donor Program.