Bone marrow is a soft, spongy material found in your large bones. It makes more than 200 billion new blood cells every day, including red blood cells, white blood cells, and platelets. But for people with bone marrow disease, including several types of cancer, the process doesn’t work properly. Often, a bone marrow transplant is a person’s best chance of survival and a possible cure. The good news is that donating bone marrow can be as easy and painless as giving blood.
What you need to know about bone marrow transplants
A bone marrow transplant replaces diseased bone marrow with healthy tissue, usually stem cells found in the blood. That’s why bone marrow transplants are also called stem cell transplants. In an allogeneic transplantation (ALLO transplant), blood stem cells from the bone marrow are transplanted from a donor into the patient. The donor stem cells can come from either the blood that circulates throughout another person’s body or from umbilical cord blood.
But there’s a catch. Before a person receives an ALLO transplant, a matching donor must be found using human leukocyte antigen (HLA) typing. This special blood test analyzes HLAs, which are specific proteins on the surface of white blood cells and other cells that make each person’s tissue type unique. HLA-matched bone marrow is less likely to cause a possible side effect of transplantation called graft vs. host disease (GVHD). GVHD is when immune cells in the transplanted tissue recognize the recipient’s body as “foreign” and attack it.
Only about 30% of people who need a transplant can find an HLA-matched donor in their immediate family. For the remaining 70% of people, doctors need to find HLA-matched bone marrow from other donors. In 2016, that equals about 14,000 people — from very young children up to older adults — in the United States who need to find a donor outside of their close family.
How a match is made
The National Marrow Donor Program (NMDP) has a registry of potential donors that might be the match a patient needs. Here’s how the donation process works:
You register with the NMDP online or in person at a donor center. You can find a center by calling the toll-free number 1-800-MARROW2.
You collect cells from your cheek with a cotton swab or provide a small blood sample. This is done by following directions in a mail-in kit or at a donor center. The sample is analyzed to determine your HLA type, which is recorded in the NMDP national database.
If an HLA match is made with a patient in need, the NMDP contacts you. A donor center takes a new sample of your blood, which is sent to the patient’s transplant center to confirm the HLA match. Once doctors confirm the match, you’d meet with a counselor from the NMDP to talk about the procedures, benefits, and risks of the donation process. You then decide whether you’re comfortable with donating.
The bone marrow donation process
If you agree to donate bone marrow, you’ll likely do what’s called a peripheral blood stem cell (PBSC) collection. Here’s how it works:
For 5 days leading up to the donation, you’ll get a daily 5-minute injection of granulocyte colony-stimulating factor (G-CSF), a white blood cell growth hormone.
On day 5, a trained health care provider will place a needle in each of your arms. One needle will remove blood, and a machine circulates the blood and collects the stem cells. Your blood then is returned to your body through the second needle. The process takes about 3 hours and may be repeated on a second donation day. Side effects include headaches, bone soreness, and discomfort from the needles during the process.
Although less common, some donors may be asked to undergo a bone marrow harvest, during which doctors take bone marrow from the back of a donor’s hip bone during surgery. Donors usually go home the same day of the surgery and can return to normal activity within 1 week. Common side effects include nausea, headache, and fatigue, most often related to the anesthesia. Bruising or discomfort in the lower back is also common.
The end result? You could help cure someone’s disease.