Bone marrow donation is a life-saving procedure for individuals facing severe blood cancers, immune system disorders, or critical illnesses. Donation provides healthy blood-forming stem cells that replace a patient’s diseased marrow. While all medical procedures carry risk, the process is generally safe for the healthy donor. This article details the side effects linked to the two distinct collection methods.
Two Distinct Donation Procedures
The donation method determines the potential side effects experienced. Most donations today use Peripheral Blood Stem Cell (PBSC) donation, a non-surgical, outpatient procedure that collects stem cells directly from the bloodstream. The less frequent method is a surgical bone marrow harvest, which requires brief hospitalization.
PBSC donation is similar to apheresis. Before collection, the donor receives daily injections of Granulocyte Colony-Stimulating Factor (G-CSF) for four to five days. The surgical harvest is performed under general or regional anesthesia, using specialized needles to withdraw liquid marrow from the back of the pelvic bone.
Side Effects of Peripheral Blood Stem Cell Donation (PBSC)
Side effects of the PBSC method are primarily linked to the G-CSF drug and the apheresis process. G-CSF stimulates the bone marrow to overproduce stem cells and push them into the peripheral blood for collection. This rapid cellular expansion frequently leads to temporary, flu-like symptoms.
The most common side effect is a dull ache or pain in the bones, often felt in the lower back, hips, or sternum. Approximately 83% of donors experience this bone pain, which is typically managed with over-the-counter pain relievers like acetaminophen. Other systemic symptoms include headaches, fatigue, and nausea, which resolve shortly after the final dose of G-CSF.
During apheresis, the donor’s blood circulates through a machine that separates the stem cells before returning the remaining components. This process requires an anticoagulant that can temporarily lower calcium levels, causing mild tingling around the lips or fingertips, muscle cramps, or lightheadedness. In rare instances, severe but temporary complications, such as splenic rupture, have been reported, emphasizing careful medical monitoring.
Side Effects of Surgical Bone Marrow Harvest
Side effects of a surgical bone marrow harvest are localized to the collection site and related to anesthesia. Since the procedure uses general or regional anesthesia, donors face temporary risks associated with sedation. Common post-anesthesia effects include mild nausea, vomiting, temporary confusion, and a sore throat from the breathing tube.
The most significant side effect is pain and discomfort at the harvest site, located at the back of the pelvic bone. This pain is often described as a deep ache or stiffness. Pain medication is provided to manage this soreness, which typically lasts for several days to a few weeks. Donors will also have small, puncture-like incisions that may be bruised and tender for one to two weeks.
There is a very low chance of localized infection at the incision site, a risk common to any surgical procedure. Donors may also experience fatigue and mild difficulty walking for a few days due to hip soreness. Only about 10% of the body’s total marrow is removed, ensuring the procedure does not weaken the donor’s immune system.
Recovery Timeline and Long-Term Health
The recovery period varies significantly depending on the donation method. PBSC donors generally recover faster, returning to normal activities within one to seven days post-collection. Systemic side effects caused by G-CSF injections subside rapidly once the drug is cleared from the body.
Recovery from the surgical bone marrow harvest takes longer due to the need for the body to heal the collection site. The median time for a donor to report a full recovery is approximately 20 days. Most donors resume light activity within one to three weeks. The body naturally regenerates the donated bone marrow or stem cells within a few weeks to a couple of months.
There are no known long-term side effects or increased health risks associated with donating bone marrow or peripheral blood stem cells. Medical follow-up monitors the donor’s blood counts and overall health to ensure a complete recovery. This support confirms the body has fully replenished the donated cells and the donor has returned to their baseline state.