Diseases like leukemia, lymphoma, multiple myeloma or bone marrow failure syndromes can affect bone marrow. Bone marrow is a spongy tissue inside bones that is rich in stem cells and helps to produce blood and immune cells. Healthy stem cells are often needed to treat these marrow-impacting diseases. This is why “stem cell transplant” and “bone marrow transplant” are often used interchangeably, the main difference being the method of collection of the stem cells.
In some cases — especially for some blood cancers — a person can use stem cells from their own body to facilitate giving higher doses of chemotherapy in an attempt to cure the disease. This is called an autologous stem cell transplant. The other option, especially when a recipient‘s bone marrow is already compromised, requires a donor to provide healthy stem cells, which is called an allogeneic stem cell transplant.
William Hogan, M.B., B.Ch., is a consultant hematologist and director of the Mayo Clinic Blood and Bone Marrow Transplant Program. Dr. Hogan says that about one-quarter of transplant recipients at Mayo Clinic receive an allogeneic transplant, which means a donor’s immune system is used in a life-sustaining and curative therapy to help eradicate disease.
“If you are selected (as a bone marrow donor), you might be a critically important part of a person’s treatment,” he says.
To help someone with an allogenic stem cell transplant, you can donate stem cells from your:
- Bone marrow. This is the surgical method to collect stem cells pioneered by E. Donnall Thomas, M.D.
- Blood. This is a common option done through a blood collection procedure, called peripheral blood stem cell donation.
Health care providers determine which type of donation is best for a person on a case-by-case basis. Factors that influence this decision can include the type of disease, the degree of donor matching, and other patient characteristics like age and remission status.
Who can donate bone marrow?
Dr. Hogan says that in the past, family members — especially fully matched siblings — were considered the best option to donate bone marrow. But the fact is that a majority of people who need a bone marrow transplant don’t have a family member who is a full match.
Additionally, cancers that require bone marrow transplants frequently affect older adults. Older adult sibling donors are more likely to have co-morbidities that can put the donor at risk and can increase the risk of complications with the recipient.
For these reasons, the National Marrow Donor Program manages a registry of bone marrow donors that can be matched with unrelated recipients.
What are the requirements for being a bone marrow donor?
To help increase the long-term survival rate of a bone marrow recipient, the National Marrow Donor Program prefers healthy donors who are 18 to 35 years old, although Dr. Hogan says that older donors can be an option in select circumstances. He says that determining a good match for a bone marrow transplant includes looking at a donor’s proteins in cells called human leukocyte antigens (HLA) and blood type. Optimal donors will match HLA and blood type and be free of genetic and infectious diseases.
Being a donor does require a time commitment, often 20 to 30 hours over 4 to 6 weeks from screening to donation. In terms of financial requirements to be a bone marrow donor through the National Marrow Donor Program, there aren’t any. All your medical and travel expenses are covered.
Donor diversity matters
The U.S. Health Resources & Services Administration states that even though there are more than 40 million potential bone marrow donors in the world, it’s harder for people with racially and ethnically diverse backgrounds to find a match.
“Getting greater diversity in the bone marrow registry is important, since ethnicity impacts HLA matching to some degree, ” says Dr. Hogan. “We need to ensure that underrepresented minorities have adequate representation. We want to provide better donors for better outcomes.”
According to the National Marrow Donor Program, people who need bone marrow are most likely to match with someone of their own ethnic background. The odds of finding a match through the bone marrow donation registry vary based on ethnic background. For example, if a recipient is white, they have a 79% chance of finding a match. If they are Hispanic or Latino, the odds of a match drop to 48%. And for recipients who are Black or African American, the chance of finding a match is just 29%.
Are there risks to being a bone marrow donor?
If you donate bone marrow, you will undergo surgery. During the surgery, you are under general anesthesia and a needle is inserted into your hip bones to collect the bone marrow. The effects of general anesthesia can include more minor complaints such as a sore throat and nausea, as well as some serious but rare complications.
Aside from the use of anesthesia, other risks of bone marrow donation surgery include:
- Infection at the site where the marrow was collected.
- Prolonged bleeding from the collection site.
- Headache.
- Pain shooting down your leg.
- Dizziness or feeling lightheaded.
Is bone-marrow donation painful?
After the surgery to collect bone marrow, you might experience pain where the needle was inserted when you bend or walk. The pain tends to lessen after the first several days and is usually gone within 6 to 12 weeks.
Dr. Hogan says that there are misconceptions about the pain associated with bone marrow donation. Many donors report that the value of their donation and the contribution to saving somebody’s life often outweighs the discomfort of the procedure, he says.
He explains that donation surgery is more involved than a blood draw, but the pain should be well managed, and most donors have a positive experience.
How long is the recovery process for the bone marrow donation procedure?
Many people take several days off following bone marrow collection surgery so that they can take rest periods throughout the day and slowly resume normal activities. After the collection, it takes a few weeks for your bone marrow to replenish, and after that, most symptoms like soreness and fatigue should be gone. The total recovery process can typically take 2 to 6 weeks, according to Dr. Hogan.
How do you join the bone marrow donation registry?
If you are highly motivated to help others, Dr. Hogan suggests that you start at the National Marrow Donor Program’s Be the Match site, where you can learn more about the process to join and what happens if you are selected as a match.
Joining the voluntary registry is a simple process. First, you’ll answer questions about your medical history in an initial screening. If you qualify, the next step is to swab the inside of your cheek to determine your HLA type. Those two steps are what it takes to join.
Once you’ve joined the registry, you might not be identified as a match until you opt out or age out when you turn 61. Once you’ve joined the registry, you can change your mind about being a donor at any time.
Even if you join the registry with the intent of helping a friend or family member, it might turn out that you’re a better match for someone you don’t know. If you do match, you might be asked to donate either bone marrow or blood, depending on what the recipient needs.
If you are selected as a match, your donation has the power to transform someone’s life.
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