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Published: August, 2010; Vol 7, Num 3

 

Blood, marrow and organ donation is essential to saving lives, but not enough people step up to the plate. In a series that began last month, LIFELINES ONLINE explores donation issues.

Marrow Donation: Lifesaving Gift from a Stranger

Every year, more than 15,000 people in the U.S. and Canada learn that they have a life-threatening disease and that their best hope for survival is a bone marrow transplant (BMT).

Alternate description

LHSFNA Management Co-Chairman
Noel C. Borck

“For many of these patients, especially those of minority populations, locating a donor is akin to finding a needle in a haystack,” says LHSFNA Management Co-Chairman Noel C. Borck. “Suitability requires testing. The donation process can have side effects. The patient and donor are usually strangers.  For all these reasons, donors willing to give marrow are in short supply, only 14 million worldwide.”  

Donation Facts

Unrelated donors must be between the ages of 18 and 60.

Registration can be done online followed by sending in a cheek swab.

Marrow donation takes place at a location convenient to the donor.

Donation is free and donor expenses are usually covered through the patient’s insurance.

Every year, over 1,000 people die because a donor with matching marrow cannot be found.Volunteer donors are needed.  

Marrow and Stem Cells

Marrow, the spongy center of the bone, creates blood stem cells that develop into oxygen-rich red blood cells. Marrow also creates infection-fighting white blood cells and platelets which enable blood to clot. Meanwhile, illnesses such as leukemia, lymphoma and sickle cell anemia and medical treatments like chemotherapy and radiation destroy blood stem cells, leaving people vulnerable to more infections and even death.  

Bone marrow transplants and peripheral blood stem cell donation (PBSC) – with “medical encouragement,” stem cells migrate from the donor’s marrow into the blood stream for collection without surgery – can restore health for those with weakened stem cell production systems.

In the past, donating always required hospitalization with donors undergoing surgery to have marrow drawn from the hipbones. Side effects included lower back soreness, muscle pain, bruising at the site of the procedure and fatigue that could last for several weeks.

PBSC is done on an outpatient basis. Blood is drawn from a vein in the donor’s arm, sent through a machine that filters out the stem cells and then returned to the donor. The procedure takes four to six hours, and a donor usually undergoes an additional two to four sessions.

PBSC also has side effects. Medication taken to draw stem cells from the bone marrow and into the blood stream can cause bone pain, muscle aches, headache, fatigue, nausea and trouble sleeping. The collection process itself can cause lightheadedness, chills, numbness or tingling around the mouth and hand cramping. Symptoms abate when the procedure ends.

Compatibility’s Importance

Ethnic Breakdown
Of Marrow Registry Donors

Caucasian: 74%

Latino: 10%

African American: 7%

Asian/Pacific Islander: 7%

Multi-Racial: 3%

Native American: 1%

Well matched marrow is crucial to transplant success. To lessen the likelihood of sometimes fatal rejection, the donor and patient must have marrow with similar human leukocyte antigen (HLA) tissue type.

Tissue type is inherited, and doctors look first to family members when a patient needs a BMT. However, only 30 percent of patients have a relative who matches and is able to donate (age and health conditions can make someone ineligible). The other 70 percent, approximately 10,000 people every year, turn to the National Marrow Donor Program’s (NMDP) globally-comprised Be The Match Registry. If a match is found, it is usually between people of similar racial and ethnic heritage.

“Medical advances continue to make BMT a treatment option for more patients, but they still must find a match,” Borck stresses. “A volunteer marrow donor gives patients hope and could be the one who saves a life. If you’re interested in helping and have questions about your viability as a donor, talk with your doctor.”

[Janet Lubman Rathner]