Frequently Asked Questions About Donating Bone Marrow

Finding a Match

    Human Leukocyte Antigen (HLA) typing begins with analyzing a sample of blood or cheek cells in a laboratory. HLA markers are found on the white blood cells (leukocytes).

    Your HLA type is inherited from your parents: one half from your mother and one half from your father. Just as you or your siblings may have inherited hair or eye color, you may also have inherited the same HLA type.

    The typing process has two steps. The first, serological typing, is a broad definition of your bone marrow type. The second, more specific, typing involves your DNA. Your bone marrow "type" is designated by a series of 10 alpha-numeric combinations. There are millions of possible combinations.

    A potential donor's markers are compared to the patient's markers to determine whether there is a match. The likelihood of finding an HLA match with a family member is 25 to 30 percent.

    Proteins called antigens are found on the surface of the white blood cells and other body tissue. Particular antigens, named HLA-A, HLA-B, HLA-C and HLA-DRB1 are essential to the success of marrow and cord blood transplants (also called BMT). These antigens are used to "match" a patient with a donor. When looking for a match it's important to remember that people of the same race and ethnic groups are more likely to match each other.

    To help match patients and unrelated donors, the NMDP Registry and other donor registries worldwide maintain a computerized registry that records the tissue type of potential volunteer donors and checks for matches.

    The U.S.-based NMDP Registry is the world's largest and most diverse donor registry with more than 12.5 million potential donors and 209,000 cord blood units.

    Doctors choose donors based on what is best for the patient. About 1 in 430 members of the NMDP Registry in the United States will go on to donate bone marrow or peripheral blood stem cells (PBSC) to a patient. We cannot predict the likelihood that an individual member will donate because there is so much diversity of tissue types in the population. However, doctors request donors in the 18-40 age group more than 95 percent of the time. That's because research shows cells from younger donors lead to more successful transplants.

    Every person who joins the registry gives patients hope, and new patient searches begin every day. You may never be identified as a match for someone, or you may be one of a number of potential matches. But you may also be the only one on the registry who can save a particular patient's life.

    Donating marrow or PBSC is a serious commitment. A last-minute change of mind may be fatal to the patient awaiting the transplant. Most people decide to go ahead with the procedure once they balance all the facts and consider what their decision will mean to themselves and the recipient. A donor is under no form of legal obligation to donate. Individual decisions are always respected.


    The Donation Process

      Before donation, a donor will receive a drug called filgrastim (via injection) to move more blood-forming cells from the marrow into the bloodstream. Stem cells are collected from the peripheral (circulating) blood in an outpatient setting using a procedure called apheresis. During apheresis, blood is removed through a needle in one arm, the stem cells are collected from the blood, and the remaining blood components are returned through the needle.

      Unlike marrow donation, PBSC donation is a non-surgical procedure, and does not require anesthesia. Marrow donors may experience pain and residual stiffness up to a few weeks after the procedure. PBSC donors experience symptoms such as bone pain and muscle pain prior to the donation while receiving filgrastim (also referred to as G-CSF), the drug used to increase the release of blood-forming cells from the bone marrow, but these symptoms go away within 24 hours of donation.

      If it has been determined you are a complete match for the patient, you will be told which method the patient's physician requests prior to your preparation to donate. You will receive further education about marrow and PBSC donation.

      You will then be asked to sign an Intent to Donate or Consent form. At this point, the donor needs to be absolutely certain about making the donation because the patient will begin to undergo treatment to prepare for the transplant.

      If you are a match for a patient, the choice of which procedure is ultimately up to you and your medical team. You may be asked to donate one stem cell source or the other depending on the transplant center, or the physician's preference for the patient.

      Before: You will be seen by a nurse practitioner or physician assistant at least two weeks before your donation to have a physical exam and blood work, and to make arrangements to receive filgrastim (also known as G-CSF, a protein that causes your bone marrow to increase the production of blood stem cells).

      You will receive filgrastim injections for five days before your stem cell collection.

      During: Your stem cells will be collected in an outpatient setting using a procedure called apheresis. During apheresis, blood is removed through a needle from one arm or through your Hickman catheter, the stem cells are collected, and the remaining blood components that are not needed for transplant are returned through a needle in the other arm.

      For apheresis collection, you will come to the Kraft Family Blood Donor Center. The collection process will take up to five to seven hours daily, usually for one or two days.

      After: You will leave the Kraft Family Donor Center the same day you donate. You will feel tired at the end of the collection process, so we recommend that someone drive you home afterwards.

      If you can, it is best to take some time off from work during the time period when you will be donating.

      Donors may experience headache or bone pain and muscle aches, similar to a cold or the flu, for several days before collection. These are side effects of the filgrastim (also called G-CSF or Neupogen) injections that disappear shortly after donation. Other common side effects are nausea, trouble sleeping and tiredness. Less than one percent of donors have an allergic reaction to filgrastim, which may include skin rashes or shortness of breath.

      There are some medications that cannot be taken while you receive filgrastim. Please let your physician and/or nurse know if you are taking any medications (prescription or over-the-counter).

      You should not drink caffeinated beverages (coffee, tea, soft drinks) or alcohol. You should not take aspirin or NSAIDs (non-steroidal anti-inflammatory drugs), which include ibuprofen, naproxen, Motrin, Advil, or Aleve. You should avoid taking Pepto-Bismol or other anti-acid liquid medications. Please let your physician and/or nurse know if you are taking any medications (prescription or over-the-counter).

      Marrow donation is done under general or spinal anesthesia so the donor experiences no pain during the collection procedure. Pain medication is commonly prescribed after marrow donation.

      Discomfort and side effects vary from person to person. Common side effects of marrow donation include:

      • Lower back pain
      • Fatigue
      • Stiffness when walking
      • Bleeding at the collection site

      Some donors say the experience was more painful than they expected; others say it was less painful. Some donors describe the pain as similar to achy hip bones or falling on their buttocks. Others say it feels more like a strained muscle in the back. The ache may last a few days to several weeks.

      You may experience side effects during the PBSC donation procedure. Some donors experience tingling around the mouth, fingers, and toes and mild muscle cramps. This is caused by the anti-coagulant (blood thinner) used in the apheresis procedure. These symptoms are easily treated by slowing down the procedure or giving the donor calcium. Less common side effects of the donation procedure are a decrease in the blood platelet count, lightheadedness, and nausea.

      Although everyone's body responds differently to the donation process, you can expect to feel tired for a few days after the time you donate and complete the filgrastim injections.

      You can take acetaminophen (one brand name is Tylenol) or any pain medication that is prescribed by your doctor.

      You may experience a wide range of emotions, including stress, anxiety, gratification, and even ambivalence about being a donor. You can talk to a clinical social worker on the donor services care team about your feelings and concerns.

      If you need to contact someone once you return home after donation, please contact your donor coordinator.

      Registering with the NMDP Registry

        No. If you'd like to become part of the NMDP Registry as a volunteer donor, you will need to complete a consent form and obtain a copy of your HLA typing.

        Your generosity as a bone marrow or stem cell donor could help a patient win his or her battle with cancer. Stem cell and bone marrow transplantation provide a potential cure for patients with primary bone marrow failure or with malignancies of the bone marrow and lymph nodes, such as leukemia and lymphomas.

        If you are in good health, between the ages of 18 and 40, and would like to become a potential donor, learn more from the NMDP website.

        The NMDP requires that volunteer marrow donors be between the ages of 18 and 40. An individual must be at least 18 because donating is a voluntary procedure that may involve surgery and the donor must be able to give informed consent.

        A guardian or parent cannot sign a release or give consent because unrelated marrow donation is a voluntary procedure and is not beneficial or lifesaving to the donor.

        Because the patient's physician may request either a marrow donation procedure (which is considered surgery) or a blood-cell donation, a volunteer must be medically eligible for both procedures.

        This age guideline does not apply to family members who are donating for a patient.


        The NMDP recognizes that chronological age does not necessarily correlate to physiological age. However, the NMDP must rely on chronological age when determining eligibility. With age comes a small increase in the risk of side effects from anesthesia, and recent NMDP studies reveal that patients receiving marrow or blood cell transplants from older donors have a somewhat poorer survival rate. These age guidelines are meant to protect the safety of the donor and provide the best possible cure for the patient. They are not meant to discriminate. This age guideline does not apply to family members who are donating for a patient.

        Becoming a volunteer donor is a serious commitment. If you join the NMDP Registry, you are asked to stay committed to donating to any anonymous patient, anywhere in the world, regardless of the patient's sex, age, race or ethnicity. You will remain on the registry until your sixty-first birthday.

        In many cases, after the patient's transplant, you can have anonymous contact facilitated through the donor center. However, each situation is unique, and in some cases (for example, owing to international regulations), contact is not possible.

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