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Questions
and Answers about
What is marrow transplantation? Marrow is the tissue that manufactures various components of the blood and the immune system: red blood cells, white cells, and platelets. Marrow transplantation is the process of taking healthy bone marrow from a donor and transplanting (transfusing) it into a patient who is suffering from a blood disease such as Leukemia, Aplastic Anemia, Lymphoma or a number of other immune system disorders. The patient also usually receives intensive chemotherapy and/or radiation therapy to destroy all cancerous cells. Who needs a marrow transplant? An estimated 40,000 adults and children are stricken with Leukemia, Lymphoma, Hodgkin's, Aplastic Anemia and other blood related cancers each year. Marrow transplantation is the only hope for many of these patients. The decision to perform a transplant is made on the basis of the diagnosis, stage of the disease, patient age, and availability of a suitably matched donor. Who can be an unrelated marrow donor? Potential unrelated volunteer donors must be at least 18 years old and meet the requirements for marrow donation. Individuals selected as unrelated marrow donors must also ultimately pass a thorough physical examination. Donors are selected on the basis of their HLA types and extensive compatibility testing. What is HLA? HLA (Human Leukocyte Antigens) are markers on the surface of white blood cells. HLA forms the basis for recognizing and rejecting foreign tissues. Matching marrow recipients and donors for their HLA type has been shown to greatly increase the likelihood of a successful transplant. HLA genes are inherited. There are over 20,000 marrow types in the general population. Thus, the greatest chance of finding a matched marrow donor exists within the patient's own family. Unfortunately, only about 25 percent of patients needing a transplant have a matched family member. So, the odds of any two unrelated individuals matching are about one in 20,000. That is why it is critical to have on file as many potential donors (of all different races and ethnic backgrounds) as possible. What happens when a person agrees to be a potential marrow donor? HLA typing will be performed on blood samples obtained during a group testing session or by the individual walking into one of many draw sites around the country (about 2-3 teaspoons of blood are taken from the donor's arm). This information is then put into a nationally recognized registry database and becomes a part of their confidential computerized file. If a patient needs a marrow transplant from an unrealted donor, the Registry conducts a computerized search to identify donors with the same HLA type as the patient. The registry will then contact the potential donor to find out if they are interested in pursuing the second phase of testing. Arrangements are then made to obtain additional blood samples to determine if full compatibility exists between donor and patient. If it's a match what next? If blood tests determine that the unrelated donor is compatible, he/she is asked to make a final commitment. Prior to the donor making this decision, the donor is provided an extensive explanation of the marrow donation procedure and a complete physical examination is performed to ensure that the prospective donor is medically eligible to donate. Only after the donor has made a final decision to donate and has passed the physical exam are arrangements made for the actual exam. What is the procedure for Donating? Marrow is removed from the on one or both sides of the upper hips area using a special syringe. The procedure is performed by an approved collection center, usually under light general anesthesia. The entire donation process lasts about one hour. The donor generally spends a night in the hospital for observation. Approximately 3 to 5 percent of your marrow is extracted. The body naturally replenishes the donated marrow in a week to 10 days, and it is not missed during that time. What are the risks? More than 20,000 transplants have been performed in the United States. To date there have been no reported long term adverse effects to any donor. Only healthy candidates are accepted and there are existing medical standards approved by the National Heart, Lung and Blood Institute to protect the donor. Donors typically experience mild discomfort and tenderness in the area where the marrow was collected, but this discomfort usually lasts just a few days and does not generally prevent normal activity. How long does it take for a marrow donor to resume normal activities? Most donors return to their normal activities, including work, within a day or two. Who covers the costs? There is no cost to the donor. Medical examinations and hospital expenses are paid by the recipient. Should I sign up and be tested to become a potential Marrow Donor? Deciding to become a potential marrow donor requires careful deliberation. We hope we have many of your questions. The next step is up to you. Thank you for taking the time to consider this very important step. For
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