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Blood and bone marrow donation
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
Blood and bone marrow donation is a voluntary process. You agree to allow doctors to draw blood stem cells from your blood or bone marrow for transplantation. Blood stem cells from blood and bone marrow donation are used to treat some cancers, such as leukemia, multiple myeloma and lymphoma, and other diseases. You might consider blood and bone marrow donation because you have a family member who needs a transplant and doctors think that you're likely to be a good match for that person.
What are blood stem cells?
Blood stem cells are the cells that make all of the body's blood cells. They form and mature in the bone marrow, and are then released into the bloodstream. Although they're called "stem cells," these cells are not the same as the embryonic stem cells studied in therapeutic cloning and other types of research.
Why it's done
Blood and bone marrow donation provides blood stem cells for transplantation. In the past, all donors had to undergo surgery to draw bone marrow containing blood stem cells from the hipbones.
Today, however, it's more common to collect blood stem cells directly from the blood. This is called peripheral blood stem cell (PBSC) donation. Blood stem cells can also be collected from umbilical cord blood at birth. However, only a small amount of blood can be retrieved from the umbilical cord, so this type of transplant is generally reserved for children and small adults.
Risks
The risks of blood and bone marrow donation are minimal. However, PBSC donation requires that you take a medication to draw more blood stem cells out of your bone marrow. This medication may cause side effects such as bone pain, muscle aches, headache, fatigue, nausea, vomiting and trouble sleeping. You can take acetaminophen for the discomfort. If that doesn't help, your doctor can prescribe pain medicine for you. These side effects usually disappear within a couple of days after you finish the injections.
The actual process of filtering the blood stem cells from your blood can also cause mild side effects, such as lightheadedness, chills, numbness or tingling around the mouth, and cramping in the hands. These can be treated and go away after you complete the donation.
What you can expect
To determine if you're a match for the person who needs the transplant, doctors use a test called human leukocyte antigen (HLA) typing. HLA proteins are inherited from your mother and father. Thus, full brothers and sisters are typically the best bet for a match. A close match increases the chances that the transplant recipient's body will accept the donated cells. If HLA typing shows that you're a good match, you'll undergo some additional tests and an examination to make sure you don't have any genetic or infectious diseases that can be passed on to the transplant recipient. Your doctor will also ask about your health and your family health history to determine whether donation will be safe for you.
If blood stem cells are going to be collected directly from your blood, you will be given medication to stimulate production of blood stem cells so that more of them are circulating in your bloodstream. That way they can be easily filtered from your blood.
The medication is typically given as an injection once a day for four days before and continuing through your donation. Your doctor will check your blood cell count. A nurse will determine which vein can be used for the donation process. If you have small veins in your arms or your veins have thin walls, you may need to have a central line put in a larger vein in your neck. This rarely causes side effects, but complications that can occur include air trapped between your lungs and your chest wall (pneumothorax), bleeding and infection.
On the fifth day, the blood stem cells are collected from your blood using a process called apheresis. During apheresis, blood is drawn out through a vein in your arm or a central line and sent through a machine that filters out the blood stem cells. After the filtering, your blood is returned to your body. Apheresis takes four to six hours and is done on an outpatient basis. You'll typically undergo two to four apheresis sessions, depending on how many blood stem cells are needed.
- Bone marrow and peripheral blood stem cell transplants. American Cancer Society. http://www.cancer.org/docroot/ETO/eto_1_3_Bone_Marrow.asp. Accessed Feb. 18, 2009.
- Bone marrow transplantation and peripheral blood stem cell transplantation. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Therapy/bone-marrow-transplant. Accessed Feb. 19, 2009.
- What are stem cells? American Cancer Society. http://www.cancer.org/docroot/ETO/content/ETO_1_4X_What_Are_Stem_Cells.asp?sitearea=ETO. Accessed Feb. 18, 2009.
- Filgrastim (granulocyte colony stimulating factor; G-CSF). Facts & Comparisons 4.0. http://www.factsandcomparisons.com. Accessed Feb. 18, 2009.
- HLA matching: Finding the best donor or cord blood unit. Be the Match Registry. Accessed May 4, 2009.
- Gronseth MJ (expert opinion). Mayo Clinic, Rochester, Minn. May 1, 2009.
