Bone marrow donation provides healthy, blood-forming stem cells to patients whose own cells have been compromised by disease or treatment. These cells are transferred to the recipient to help rebuild their immune system and blood production capabilities. This is a life-saving treatment for individuals diagnosed with blood cancers like leukemia and lymphoma, as well as certain other blood disorders. The donor’s experience depends on which of the two primary collection methods is selected.
Peripheral Blood Stem Cell Donation
Approximately 90% of modern blood-forming cell donations use a non-surgical method called Peripheral Blood Stem Cell (PBSC) donation. This approach utilizes the body’s natural ability to circulate stem cells and is similar to donating plasma. Before the donation, the donor undergoes a preparatory phase involving injections of a synthetic growth factor called granulocyte colony-stimulating factor (G-CSF).
The G-CSF drug is administered daily for four to five days leading up to collection. Its purpose is to stimulate the bone marrow to produce a surplus of stem cells and push them into the bloodstream. While effective, the drug often causes temporary, flu-like symptoms because the marrow is actively stimulated. Donors commonly report bone pain, particularly in the lower back and pelvis, along with headaches and fatigue, which are managed with over-the-counter medication.
On the day of the procedure, the donor is fully awake and reclined comfortably for the duration of the collection. The process, called apheresis, involves drawing blood from a needle in one arm and circulating it through a specialized machine. This machine filters and separates the blood to collect the stem cells. The remaining blood components are then returned to the donor through a needle in the other arm.
The apheresis procedure typically takes between four and eight hours, depending on the required cell count and the donor’s blood flow rate. Because the donor is conscious, they are free to read, watch a movie, or talk during the collection. Some donors may experience temporary side effects during apheresis, such as tingling around the mouth or mild muscle cramps. These occur due to the anticoagulant used to prevent blood clotting and are easily corrected by administering calcium supplements.
Surgical Bone Marrow Harvest
The second, less frequent method of collection is the surgical bone marrow harvest. This method requires the direct collection of liquid marrow from the pelvic bone, or iliac crest. Unlike the PBSC method, the donor is not awake during this procedure.
The surgical harvest is performed in a hospital operating room. The donor is given either general anesthesia or a heavy regional (epidural) anesthetic. General anesthesia ensures the donor is completely unconscious throughout the entire process, meaning they feel no pain or sensation during the collection.
Once the anesthesia is effective, the donor is positioned face-down. A sterile hollow needle is inserted through the skin into the back of the pelvic bone. Multiple small aspirations are performed to withdraw the liquid marrow, which is rich in blood-forming cells. The procedure is relatively quick, usually lasting one to two hours. The volume collected is small, generally less than 5% of the donor’s total marrow.
The incisions made by the needle are small, often requiring only a small bandage, not stitches. The primary concern with this method is the localized soreness that follows the collection. This surgical method is reserved for situations where the recipient is a young child or when the transplant physician determines that liquid marrow is the necessary source of stem cells.
Immediate Post-Procedure Experience
The immediate recovery experience differs based on the collection method, primarily due to the type of anesthesia and the extraction location. Donors who undergo the surgical harvest wake up in the recovery room and may feel groggy or slightly nauseous as the anesthesia wears off. They will experience soreness and bruising at the collection site in the lower back or hip, often described as similar to a deep bruise.
Pain following a surgical harvest is managed with prescription or stronger over-the-counter medication for a few days. Most donors are released from the hospital within 24 hours. While many individuals return to work or school within one week, the median time for feeling fully recovered is approximately three weeks.
In contrast, PBSC donors experience a much quicker recovery since they were awake throughout the apheresis procedure. The flu-like symptoms caused by the G-CSF injections fade rapidly, often within 48 hours of the final dose. The most common immediate side effects are fatigue and potential bruising at the needle insertion sites in the arms.
Most PBSC donors feel well enough to return to their normal daily activities, including work and school, within one to two days. Regardless of the method, the body naturally replaces the donated cells within a few weeks. All donors are closely monitored to ensure a safe transition back to their daily lives.