The decision to become a bone marrow donor offers a chance at life for patients battling life-threatening blood cancers, such as leukemia and lymphoma, or other severe blood disorders. For these individuals, a transplant of healthy blood-forming cells is often the only hope for a cure. This guide explains the commitment and criteria involved in becoming a registered donor and the procedures that follow if you are matched with a patient in need.
Eligibility Requirements for Joining the Registry
Potential donors must meet specific age and health criteria to ensure the safety of both the donor and the patient. Most major registries accept new registrants between the ages of 18 and 60, but the ideal age range is 18 to 44 years old. Younger donors are preferred because their stem cells often lead to better transplant success rates for patients.
A comprehensive health questionnaire screens for disqualifying medical conditions. Certain chronic diseases, including severe autoimmune disorders (like lupus or multiple sclerosis), a history of certain cancers, or heart disease, prevent joining the registry. This process ensures the donor is in excellent health and that the donation procedure poses no undue risk.
The Process of Registration and Initial Screening
To join the registry, request a registration kit online through a national donor program. The kit contains supplies for a simple, non-invasive cheek swab to collect a DNA sample. After swabbing the inside of your cheek, you mail the kit back to the registry.
The sample is used for Human Leukocyte Antigen (HLA) typing, which identifies a unique set of proteins on the surface of your cells. HLA markers function as a genetic fingerprint, and a close match between a donor and patient is necessary for a successful transplant. Once your HLA type is determined, your information is added to the database, making you searchable worldwide. While joining is a commitment to donate if matched, the chance of being called upon is low because few people share the exact same tissue type.
Understanding the Two Methods of Donation
If you are identified as a match, a transplant center will determine the best method of donation for the patient, which will be either Peripheral Blood Stem Cell (PBSC) donation or a surgical Marrow Donation. PBSC donation is the most common method, accounting for approximately 80% to 90% of all donations. This procedure is non-surgical and closely resembles donating platelets.
Peripheral Blood Stem Cell (PBSC) Donation
For five days before the PBSC donation, the donor receives daily injections of a medication called filgrastim. This growth factor stimulates the bone marrow to produce and release blood-forming stem cells into the bloodstream. The donation itself is performed using apheresis, where blood is drawn from one arm and passed through a machine that separates and collects the stem cells. The remaining blood components are returned to the donor through the other arm. The entire outpatient process typically takes between four and eight hours.
Marrow Donation
Marrow Donation is a surgical procedure performed in a hospital under general or regional anesthesia. Sterile, hollow needles withdraw liquid marrow from the posterior iliac crest (the back of the pelvic bone). The procedure usually lasts about one to two hours. The amount collected is a small fraction of the donor’s total marrow, which the body quickly replaces. This procedure is generally reserved for cases where the patient’s condition necessitates the collection of pure bone marrow.
Post-Donation Recovery and Follow-Up
Recovery time and side effects vary by donation method. For PBSC donation, the median time to full recovery is about one week, with donors often feeling recovered within one to seven days. Side effects stem from the filgrastim injections and can include headache, fatigue, or bone and muscle aches, which resolve shortly after the donation.
Recovery from surgical Marrow Donation typically takes longer, with a median time to full recovery of about 20 days. Most donors return to normal activities within two to seven days. Donors may experience soreness, bruising, and discomfort in the lower back or hip area for a few days, managed with over-the-counter pain medication. Donor registries cover all donation-related costs, including travel, accommodation, and medical follow-up. The body naturally replenishes the donated blood-forming cells within a few weeks.