Bone marrow donation is a medical procedure where healthy blood-forming cells, also known as hematopoietic stem cells, are collected from a donor. These cells are then transplanted into a patient whose own bone marrow is diseased or damaged, replacing the unhealthy cells with healthy ones. The donated cells enable the patient’s body to produce new, healthy blood cells, offering a chance for recovery and improved health.
The Lifesaving Purpose of Bone Marrow Donation
Bone marrow donation treats numerous serious medical conditions. Patients with blood cancers like leukemia, lymphoma, and multiple myeloma often require a bone marrow transplant. It also treats severe aplastic anemia, where the bone marrow fails to produce enough blood cells, and sickle cell disease, a genetic blood disorder.
The transplant procedure replaces the patient’s unhealthy bone marrow with healthy functioning bone marrow from the donor. This allows the patient to regenerate a new immune system capable of fighting existing diseases or restoring normal blood cell production. For some conditions, especially those resistant to other treatments, a blood stem cell transplant offers a vital treatment option.
Becoming a Registered Donor
Individuals interested in becoming a bone marrow donor can join a national or international registry, such as Be The Match in the U.S. Initial steps involve a health questionnaire and a cheek swab for Human Leukocyte Antigen (HLA) typing.
HLA markers are proteins on cell surfaces that the immune system uses to distinguish between its own cells and foreign invaders. A close HLA match between the donor and patient increases transplant success. Registries accept donors aged 18 to 60, with better outcomes observed for those aged 18 to 44. Donors must also meet general health requirements, as certain medical conditions can disqualify them.
Understanding the Two Donation Methods
Two methods exist for collecting healthy blood-forming cells for transplant: peripheral blood stem cell (PBSC) donation and marrow donation. The chosen method depends on the patient’s medical needs and the transplant center’s preference.
Peripheral Blood Stem Cell (PBSC) Donation
PBSC donation is the more common method, accounting for about 90% of all donations. This non-surgical procedure is similar to donating plasma. Before donation, the donor receives daily injections of Filgrastim for about five days. This medication stimulates the bone marrow to produce and release more blood stem cells into the bloodstream. On donation day, blood is drawn from one arm, passed through an apheresis machine to collect stem cells, and the remaining blood components are returned to the donor through the other arm. This outpatient procedure takes between four and eight hours, and may sometimes require a second session.
Marrow Donation
Marrow donation is a surgical procedure performed under general or regional anesthesia. Sterile needles are inserted into the back of the donor’s pelvic bone to draw out liquid marrow. The amount collected varies by the patient’s weight but represents a small fraction, around 1% to 5%, of the donor’s total marrow. The procedure lasts 1 to 2 hours, with donors lying on their stomach for access to the pelvic bone.
Donor Safety and Recovery
Following a bone marrow donation, donors experience a recovery period, with side effects and recovery times varying by donation method. Serious complications are rare for both procedures. The body naturally replaces the donated cells within a few weeks to months.
PBSC Donation Recovery
For PBSC donation, common side effects relate to Filgrastim injections, including flu-like symptoms, bone or muscle aches, headaches, and fatigue. These symptoms develop gradually over a few days and subside within 48 hours after donation. Recovery time is about one week, with many feeling fully recovered within two to three days.
Marrow Donation Recovery
Marrow donation involves surgical recovery, with common side effects including soreness, bruising, and discomfort at the collection site in the lower back or hip. Donors may also experience fatigue, muscle aches, or headaches. While some donors can return to light activities within a few days, recovery for marrow donation is longer, ranging from a few days to several weeks, with a median of three weeks. Pain relievers can help manage discomfort, and avoiding strenuous activity for about a week is recommended.