- Myths and facts about bone marrow donation
- FACT: Donating is less painful than you probably think.
- FACT: Most blood stem cell donors give peripheral blood stem cells—a process similar to donating plasma.
- FACT: There are few risks to donating.
- FACT: It doesn’t take long to save someone’s life.
- FACT: Donation is absolutely free to the donor.
- FACT: We protect your privacy and confidentiality.
- FACT: Ethnic background is an important factor for matching donors and patients.
- FACT: Members of the LGBTQ+ community CAN join the registry and donate.
- FACT: Age guidelines protect the safety of the donor and provide the best possible outcome for the patient. They are not meant to discriminate.
- Donor leave, tax credits and cost
- Donor & Transplant Costs
- 6 Common Myths About Bone Marrow Donation Debunked
- MYTH #1 Bone Marrow Donation Is Painful
- MYTH #2 Bone Marrow Donation May Have Long-Term Consequences
- MYTH #3 Bone Marrow Is Taken From the Spine
- MYTH #4 Bone Marrow Donation Is Expensive
- MYTH #5 Bone Marrow Donation Is Time-Consuming
- MYTH #6 Family Members Can Donate All Needed Bone Marrow
- Living Blood & Marrow Donation
- Bone Marrow Donation
- Fact and Fiction: The Truth about Donating Bone Marrow
- Bone marrow transplant
- Myth 1: Stem cell donations always come from the bone marrow.
- Myth 2: Making a stem cell donation is difficult and painful.
- Myth 3: Stem cell donation is inconvenient.
- Myth 4: Most patients can find a stem cell donor in their own family, so there’s no reason to join the registry.
- Myth 5: There are plenty of people already in the stem cell donor registry, so my contribution isn’t needed.
- Myth 6: Getting into the stem cell donor registry is a hassle.
Myths and facts about bone marrow donation
FACT: Donating is less painful than you probably think.
Many mistakenly believe that donating blood stem cells is painful, when in reality it’s not.
- While TV shows and movies have wildly exaggerated blood stem cell donation—especially bone marrow donation—as something scary, the reality is much less dramatic.
- Discomfort during recovery varies from person to person. Side effects may include back pain, fatigue, headache or bruising for a few days or weeks.
- The vast majority of donors say it was worth it to help save a life, and they would do it again.
Linda, marrow donor
FACT: Most blood stem cell donors give peripheral blood stem cells—a process similar to donating plasma.
Some think that the only way to donate blood stem cells is through a surgical procedure. The reality is that 77% of donations are peripheral blood stem cells, which involves no surgery at all!
- PBSC donation is a nonsurgical procedure and the most common way to donate. For 5 days leading up to donation, you will be given injections of a drug called filgrastim to increase the number of cells in your bloodstream that are used for transplant. Some of your blood is then removed through a needle in one arm and passed through a machine that separates out the blood-forming cells. The remaining blood is returned to you through the other arm.
- Bone marrow donation is a surgical, usually outpatient procedure. You will receive anesthesia and feel no pain during the donation. Doctors use a needle to withdraw liquid marrow from the back of your pelvic bone via two small punctures.
Watch the video below to see a Lauren’s experience with donation
The patient’s doctor chooses the donation method that is best for the patient.
FACT: There are few risks to donating.
It is a common misconception that donating blood stem cells is dangerous. The truth is that there are actually very few risks in donating blood stem cells!
- Protecting the safety of our donors and maintaining the public’s trust is essential to saving lives.
- All donors are carefully prescreened to ensure they are healthy and the procedure is safe for them.
- There are rarely any long-term side effects from donating either PBSC or marrow. The donor’s immune system stays strong, and their blood stem cells replenish themselves in 4 to 6 weeks.
- While no medical procedure is completely risk free, every precaution is taken to ensure the safety and well-being of the donor.
- Because only 1 to 5% or less of your marrow is needed to save the patient’s life, your immune system stays strong.
FACT: It doesn’t take long to save someone’s life.
It’s actually a myth that the donation process takes a long time!
- Online registration takes about 10 minutes. Completing and returning a cheek swab kit only takes a few minutes.
- If you’re called to donate, the typical time commitment for the donation process is 20-30 hours spread out over a four-to- six-week period. This includes phone calls, appointments and the donation.
Akeem, peripheral blood stem cell (PBSC) donor
FACT: Donation is absolutely free to the donor.
Many people think that donating to a patient in need is expensive for them, but Be The Match covers every cost related to donation!
- Be The Match covers travel, meals and hotel for donors and one companion.
- All medical costs for the donation procedure are covered by the patient’s medical insurance or Be The Match.
FACT: We protect your privacy and confidentiality.
Sharing your personal information and DNA sample with us is NOT risky, because Be The Match has rules in place to protect your privacy.
- Maintaining your trust is essential to saving lives. That’s why your personal identifying information will not be shared with any companies or government agencies.
- We have rules in place to protect the rights and privacy of both donors and patients.
- Information about your genetic type and the stored sample from your cheek swab are identified by a code and stored separate from your personal identifying information.
FACT: Ethnic background is an important factor for matching donors and patients.
- Patients are most likely to match someone of the same ethnic background. That’s because genetic type is inherited.
- Adding more registry members who increase the ethnic diversity of the registry increases the variety of tissue types available, helping more patients find the match they need.
- Black or African American American
- Indian or Alaska Native
- Asian, including South Asian
- Native Hawaiian or other Pacific Islander
- Hispanic or Latino
Searching patients especially need more donors who identify as:
FACT: Members of the LGBTQ+ community CAN join the registry and donate.
It is a common misconception that gay men and other members of the LGBTQ+ community cannot join the registry or donate blood stem cells, when the reality is the exact opposite!
- Be The Match does not ask about members’ sexual orientation.
- For medical reasons, transsexual and non-binary individuals are asked to provide their sex assigned at birth when they register. Should you be called as a match, pronouns and gender identity are respected throughout the process.
FACT: Age guidelines protect the safety of the donor and provide the best possible outcome for the patient. They are not meant to discriminate.
Some believe that the age guidelines we have in place are to discriminate against those 45 and older. However, these guidelines are meant to protect the safety of the patient AND the donor.
- Donors between the ages of 18 & 44 provide the greatest chance for transplant success.
- Doctors request donors in the 18-44 age group 86% of the time.
- Learn more about why a donor’s age matters.
Total cost to add a new member to the Be The Match Registry is about $100. To best serve patients and demonstrate responsible stewardship over the funds entrusted to us, we require individuals age 45+ to cover their own cost to join. There are many ways you can help even if donation is not an option:
- Host a drive
- Spread the word
Donor leave, tax credits and cost
Donating bone marrow or blood cells is an opportunity to help save a life, but there is a time commitment. The typical time commitment for the donation process is 20-30 hours of your time spread out over a four-to-six-week period and requires 3 to 7 days of time off from work. Many companies and organizations have established donor leave policies that provide up to 7 days of paid leave for bone marrow or PBSC donors. If your company or organization is interested in more information on establishing a paid donor leave program, please reference our Donor Paid Leave Materials.
State laws regarding donor leave or tax credits/deductions
Some states have laws requiring employers to provide either paid or unpaid donor leave. Some states also provide a state income tax credit or tax deduction for donation-related expenses, such as lost wages. See state policies here regarding donor leave and tax credits or deductions here: Donor Leave Statutes by State
Donors never have to pay to donate. Medical, travel and most non-medical donation-related costs are covered by Be The Match® or the patient’s medical insurance.
Donor & Transplant Costs
Donor Search Fees for the 70 Percent of Patients Needing an Unrelated Donor to Proceed with Transplant: A preliminary search of the “Be The Match” registry, other small registries and cord blood registries is done free of charge by the National Marrow Donor Program (NMDP). A formal search with more specific typing is not free and is only initiated at a transplant center that is F.A.C.T accredited and contracted with NMDP, this initial cost is $4,000. Depending on the formal search results, this cost can be tens of thousands of dollars until the best compatible donor is identified.
Cord Blood Unit Donor Expenses: For a Transplant facility that is not contracted with the NMDP or F.A.C.T accredited, a cord blood search for a compatible donor can be obtained through a few cord blood centers that also operate independent of the NMDP. If a compatible cord blood unit is identified at an independent center the total fee for one cord that includes testing and shipping runs around $35,000. In some cases, a double cord is needed for engraftment changing this cost to $70,000. This fee is for the donor unit only, as other outpatient cost occurs for all families with a family donor or an unrelated donor that are not covered by insurance.
The patient’s transplant center will assist the parents in determining if their insurance will cover the testing of donors. If you don’t have this coverage, they will be told of their financial responsibility. It may range from $10,000 to $25,000 initially. This cost can be covered by Kids Beating Cancer’s “Fund the Match” program.
Compatibility Testing: Once a potential donor is identified, additional testing will be performed and prices for these tests vary depending on many factors. The variables or costs are when a patient has several siblings, as each will need to be tested at the same time. Some centers require advance payment to cover these compatibility tests. Frequently, more than one test is done. These fees may or may not be reimbursed by insurance or government agencies.
Donor Typing of Family and Friends: There is a fee for each HLA lab test done. This is due to the cost of the sophisticated DNA lab work necessary to identify the best possible matching donor. Siblings are tested first and then other family members may wish to be tested. Insurance companies will generally cover testing of siblings, parents and the patient, but not cover additional family members.
Marrow Stem Cell Harvest and Donor Expenses: The cost of the actual collection of cells from the adult unrelated or family-related donor, his/her medical tests and possible travel expenses may be high. Usually there is a fixed fee for the collection and delivery of marrow stem cells. The average rate is about $3,500–$5,000 if it’s a related donor. The average rate for an unrelated donor is $15,000–$50,000. Donors are not paid for any part of their stem cell donation.
The Actual Transplant: The procedure is very expensive. Total cost can run up to $450,000. Insurance companies vary widely on coverage. It is possible that much of the patient’s transplant, if not the entire cost, will be covered by insurance or Medicaid.
Post-transplant: It’s difficult to predict a family’s expenses after the transplant. Much will depend on the child’s recovery time, which may range from six months to a year or more. The patient’s insurance company will probably cover testing and may also cover follow-up visits and procedures. However, there are many out-of-pocket expenses. Medications can be very costly, especially if the patient does not have prescription coverage. Even with coverage, co-payments add up over the weeks and months along with other out-of-pocket expenses that can bankrupt and destroy the family.
6 Common Myths About Bone Marrow Donation Debunked
By Carina Ortel, Special to Everyday Health
Bone marrow is the soft tissue inside certain bones where stem cells — immature cells that can become any type of blood cell — are produced. A bone marrow (or stem cell) transplant is done when a disease has affected the bone marrow’s ability to produce healthy blood cells or when high doses of chemotherapy have destroyed it.
Stem cell transplants are commonly used to treat blood cancers such as leukemia, lymphoma, and multiple myeloma.
In some cases, a person’s own bone marrow — or stem cells derived from his own blood — can be collected before chemotherapy and then returned to his body to produce new blood cells.
In other cases, the stem cells from bone marrow or blood must come from a donor with a similar blood type and other blood characteristics.
However, not every person in need of a stem cell transplant finds a good donor match. That’s why building the pool of registered donors is so important: to increase the chance of finding matches for all patients so they can beat the odds.
Unfortunately, common myths about bone marrow donation too often keep people from registering as donors.
As CEO of DKMS US, a nonprofit committed to fighting blood cancer, I encourage everyone interested in saving a life to learn the facts about bone marrow donation and make an informed decision about joining the fight against blood cancers and related disorders.
Here are the facts behind six common misconceptions about bone marrow donation:
MYTH #1 Bone Marrow Donation Is Painful
These days, there are actually two ways you can donate stem cells: via peripheral blood stem cell donation or via bone marrow donation. While there is some pain associated with both methods, the amount of discomfort varies from method to method and person to person.
In peripheral blood stem cell donation, stem cells are collected from the bloodstream using a nonsurgical, outpatient procedure called apheresis. First, for five days prior to donation, the donor is given injections of a drug called filgrastim that increases the number of stem cells in his blood. The donation itself involves having blood removed through a needle in one arm and returned to the body through a needle inserted in the other arm. Peripheral blood stem cell donation takes about 4 to 8 hours on 1 to 2 consecutive days, and the donor typically goes home the same day he donates.
For bone marrow donation, marrow cells are collected from the back of the pelvic bone using a syringe. The donor receives general anesthesia, so no pain is experienced during the extraction, which takes about 1 to 2 hours. The donor may experience back or hip pain for a few days or even a few weeks afterward.
For bone marrow donation, there can be an overnight stay in the hospital.
MYTH #2 Bone Marrow Donation May Have Long-Term Consequences
Over the long term, donating stem cells by either method is relatively harmless to the donor. Bone marrow levels typically return to normal within a few weeks of the donation, and donors can return to school, work, or most other activities within 1 to 7 days.
In the short term, the drug filgrastim, used in peripheral stem cell donation, may cause nausea, vomiting, bone pain, muscle aches, fatigue, and headache.
The use of anesthesia during bone marrow donation may cause the donor to feel tired or weak or to have trouble walking for a few days. And, as noted above, bone marrow donation can cause back or hip pain for days or weeks, as well as headache, fatigue, and bruising.
MYTH #3 Bone Marrow Is Taken From the Spine
Bone marrow donations have nothing to do with the spine. Peripheral blood stem cell donation — the method used in about 75 percent of cases — involves collecting blood stem cells from the bloodstream.
For bone marrow donation, which is the less common method, marrow is extracted from the back of the donor’s pelvic bone — not the spine — using a special syringe.
MYTH #4 Bone Marrow Donation Is Expensive
A bone marrow transplant procedure is expensive, but there is no cost to the donor for donating bone marrow or stem cells.
For donors who register with DKMS, the organization will take care of your travel costs, meals, and lodging expenses, and the patient’s health insurance covers the costs of pre-donation exams and the donation procedure itself.
Other nonprofit bone marrow registries help donors in similar ways.
DKMS will also cover the costs for a companion to travel to the donation with you. Your own health insurance will never be used. Additionally, if your employer does not provide paid time off for the donation, DKMS has a financial assistance program for compensation of lost wages.
MYTH #5 Bone Marrow Donation Is Time-Consuming
In most cases, donors are asked to donate within one to three months after receiving a request. DKMS will always try to accommodate the donor’s schedule.
For peripheral stem cell donations, the donor must visit a medical office for filgrastim injections for the five days before the procedure, and then the donation takes roughly four to six hours over the course of one day. Donors typically do not stay overnight in the hospital, and most are able to return to work, school and their normal schedule within a few days.
The bone marrow extraction process takes one to two hours, and donors may stay overnight at the hospital. Even so, most are able to return to their normal schedule within days.
MYTH #6 Family Members Can Donate All Needed Bone Marrow
Each year, more than 170,000 Americans are diagnosed with hematologic cancers — cancers of the blood, bone marrow, and lymph nodes. That’s one diagnosis every 3 minutes. Every 10 minutes a person dies from one of these diseases.
When a stem cell transplant is being considered, doctors look to patients’ families first for a match, starting with siblings, who have a 1 in 4 chance of being a close match.
But only 30 percent of patients are fortunate enough to find a match within their own family. The vast majority of patients in need of a transplant must rely on donors outside their families.
The need for donors is critical, especially for those from racially and ethnically diverse communities, who face much lower odds of being able to find a match.
Being a bone marrow donor is a serious commitment, but the reward is priceless: You can save someone’s life.
Swabbing your cheek is all it takes to register as a potential donor. For more information or to register, please visit dkms.org.
Carina Ortel is CEO of DKMS US, a nonprofit organization dedicated to eradicating blood cancers by inspiring men and women around the world to register as bone marrow and blood stem cell donors.
Photo, top: Boissonnet/Alamy
Photo, bottom provided by the author
Her family came together to donate their own bone marrow, but no match was found. Finding a bone marrow match is not as straightforward as blood donation, as it goes beyond the A,B,O blood type and depends upon the compatibility of inherited genetic markers on both the donor and patient’s blood cells known as HLA antigens. While we may think that most donors come from family members of the patient, it is estimated that only 30 per cent of donors are actually related. For those that do not have a match in their family, the only hope for survival is to find an anonymous donor.
And this is what happened for my young patient.
Her doctors reached out to the Canadian Blood Services’ One Match program, a registry of all potential bone marrow donors in Canada. While it is a simple process to register, it is also a commitment that needs to be taken seriously. Once you register, you will only be called if you are a potential match. At this point, you will be asked to go through a physical exam and extra tests to ensure that you are truly compatible. Once this process is complete, the donation occurs, which can take two forms: a bone marrow donation or a peripheral blood donation.
The less invasive peripheral blood donation can be done by a simple blood draw, while the bone marrow donation is a minor surgical procedure. The latter involves removal of bone marrow from the iliac crest (hip bone). It can be painful but it is done under anesthetic to make it more comfortable for the donor. Bone marrow donation is a safe procedure but does carry a low risk of potential pain and infection, and risks associated with anesthesia. Some donors can feel tired after donating their bone marrow which can take days to weeks to resolve. Once your stem cells are donated, your body will replenish your supply within six weeks.
Due to the kindness of a volunteer donor, a match was found for my patient. She successfully had a bone marrow transplant, recovered beautifully and is now entering Grade 2 this fall.
In Canada, there are about 1000 people every day on a wait list for a stem cell or bone marrow transplant. My patient is one example of many that was able to recover from her illness due to the generosity of a stranger. We all have this potential to help, so while there are some risks to consider, I believe it is a worthwhile commitment to make.
Story continues below advertisement
Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens’ Health Centre, works as a staff physician at St. Michael’s Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women’s Habitat Shelter in Etobicoke.
Our Health Experts will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.
The content provided in The Globe and Mail’s Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.
Living Blood & Marrow Donation
Bone Marrow Donation
The procedure to collect donated bone marrow is called a bone marrow harvest. This is a surgical procedure that takes place in the operating room. During the procedure, the donor is given anesthesia so they will not feel pain. Once the donor is anesthetized, the surgeon removes bone marrow using a sterile needle that is inserted into the donor’s rear hip bones. He or she extracts the bone marrow – a thick red liquid and places it into a bag for the recipient. The harvested bone marrow, containing the life-saving stem cells, is then processed to remove impurities before being administered to the recipient.
While the donor may have several skin punctures during the harvest, there are no surgical incisions requiring stitches. After the harvest, a sterile dressing is applied and the donor is moved to a recovery area where he or she can be closely monitored until the anesthesia wears off. The donor may return home that day or stay overnight in the hospital if necessary.
Following the harvest, donors may feel pain or soreness in their lower back for several days. This can be controlled with over-the counter pain medications or for moderate pain, a prescription may be given. Most donors will feel fatigued for several days after the harvest and are able to resume normal activities within a week.
Fact and Fiction: The Truth about Donating Bone Marrow
An updated 2019 version of this article is available: !
Let’s face it: when it comes to donating bone marrow, people have a lot of misconceptions and fears. First and foremost, donating bone marrow is completely voluntary. It sounds scarier than it is, and though a person between the ages of 18 and 60 can register (as long as they’re in good health), you may never be called to donate! That is not to say it’s not important to register; someday, you could have the opportunity to save a life.
Many times, people believe that patients needing bone marrow transplants will receive their transplant from someone they are related to, whether that be a sibling, parent, or other relative. In actuality, over 75% of patients will receive marrow from a stranger, which means there is only a 25% chance that their match will be from a blood relative! A person’s best chance of finding a match lies with someone from a similar ethnic background, and if the patient’s ethnicity is in the minority, it can be very difficult to find a donor.
Another myth that surrounds bone marrow donation is the idea that it is dangerous and painful, requiring an invasive surgery that can debilitate the donor. This is not the case! It’s true that no medical procedure is without risk, but there are rarely any long-term side effects from donating marrow. Only 4 to 6 percent of a person’s healthy marrow is needed to save a life, so the donor’s immune system is not in jeopardy and the cells replace themselves within four to six weeks. There is some discomfort when donating bone marrow, but it is not exceedingly painful, and there is no long-term recovery!
There are two ways to donate bone marrow. The first is a Peripheral Blood Stem Cell (PBSC) donation. The process is pretty simple; for five days prior to donating, you are injected with a drug called filgrastim, which stimulates production of white blood stem cells. During a procedure called Apheresis, blood is taken out through a needle in an arm vein, (like when donating blood for a general health checkup) sent through a machine that separates the white blood stem cells from everything else, and the rest of the blood is returned to you through a vein in the other arm; the entire process takes around 4-6 hours. PBSC donors may experience flu-like symptoms but most symptoms will disappear, and you will be back to your normal routine within a few days.
Donating bone marrow is a type of surgery, and donors are put under regional or general anesthesia, so there is no pain during the actual procedure. Needles are inserted through the skin and the doctor withdraws liquid marrow from the back of your pelvic bone. Many believe that pieces of bone are removed, but this is not true! Only liquid marrow is removed, and it replaces itself in 4-6 weeks. Only around a quart of marrow and blood is collected, which is minimal but life-saving. Most donors go home the same day as donating, and while some experience soreness in their lower back for a couple weeks, most marrow donors are back to their normal routine within 2-7 days.
Yes, it sounds scary, but the risk is minimal, and the potential to save a life is infinitely worth it. Today, 80% of donors go through PBSC donation, and the surgical procedure has become increasingly less frequent. For more information on bone marrow donation or becoming a donor, please visit Gift of Life’s website,
Bone marrow transplant
Before the transplant, chemotherapy, radiation, or both may be given. This may be done in 2 ways:
- Ablative (myeloablative) treatment. High-dose chemotherapy, radiation, or both are given to kill any cancer cells. This also kills all healthy bone marrow that remains, and allows new stem cells to grow in the bone marrow.
- Reduced intensity treatment, also called a mini transplant. Lower doses of chemotherapy and radiation are given before a transplant. This allows older people, and those with other health problems to have a transplant.
There are three kinds of bone marrow transplants:
- Autologous bone marrow transplant. The term auto means self. Stem cells are removed from you before you receive high-dose chemotherapy or radiation treatment. The stem cells are stored in a freezer. After high-dose chemotherapy or radiation treatments, your stems cells are put back in your body to make normal blood cells. This is called a rescue transplant.
- Allogeneic bone marrow transplant. The term allo means other. Stem cells are removed from another person, called a donor. Most times, the donor’s genes must at least partly match your genes. Special tests are done to see if a donor is a good match for you. A brother or sister is most likely to be a good match. Sometimes parents, children, and other relatives are good matches. Donors who are not related to you, yet still match, may be found through national bone marrow registries.
- Umbilical cord blood transplant. This is a type of allogeneic transplant. Stem cells are removed from a newborn baby’s umbilical cord right after birth. The stem cells are frozen and stored until they are needed for a transplant. Umbilical cord blood cells are very immature so there is less of a need for perfect matching. Due to the smaller number of stem cells, blood counts take much longer to recover.
A stem cell transplant is usually done after chemotherapy and radiation is complete. The stem cells are delivered into your bloodstream usually through a tube called a central venous catheter. The process is similar to getting a blood transfusion. The stem cells travel through the blood into the bone marrow. Most times, no surgery is needed.
Donor stem cells can be collected in two ways:
- Bone marrow harvest. This minor surgery is done under general anesthesia. This means the donor will be asleep and pain-free during the procedure. The bone marrow is removed from the back of both hip bones. The amount of marrow removed depends on the weight of the person who is receiving it.
- Leukapheresis. First, the donor is given several days of shots to help stem cells move from the bone marrow into the blood. During leukapheresis, blood is removed from the donor through an IV line. The part of white blood cells that contains stem cells is then separated in a machine and removed to be later given to the recipient. The red blood cells are returned to the donor.
What would you do if you found out that your bone marrow was a match for someone who needed it — even a complete stranger?
Bone marrow and stem cell transplants are a lifesaving treatment for many people with blood cancers like leukemia and lymphoma, as well as some other blood diseases.
During a transplant, patients are given high doses of chemotherapy and sometimes radiation to wipe out their cancer. These powerful treatments also destroy the blood-making cells, however. So the next step is for healthy blood stem cells to be infused into the body, enabling the patients to grow new blood cells and recover from the treatment.
Although some patients can use their own stem cells to rebuild the blood, many patients — especially those with leukemia whose blood stem cells may themselves be cancerous — need a donor to provide the cells that will enable them to recover.
One way that donors are found is through the National Marrow Donor Program, a group that maintains a registry to match unrelated volunteer donors with patients in need. Many people are reluctant to join this registry because they don’t understand what’s involved or how important their donation may be. We spoke to Parastoo Dahi, a hematologist and medical oncologist at Memorial Sloan Kettering who specializes in stem cell transplantation, about some of the myths surrounding bone marrow and stem cell donation.
Myth 1: Stem cell donations always come from the bone marrow.
“We still commonly use the term ‘bone marrow transplant,’ but more often than not, what we really mean is a transplant using stem cells that are removed from the bloodstream rather than the marrow,” Dr. Dahi says.
The doctor performing the transplant will decide which procedure will be used to extract the stem cells based on what he or she thinks will be best for the recipient. But the majority of donations are taken from the blood, not the bone marrow.
Back to top Arrow (up) icon.
Myth 2: Making a stem cell donation is difficult and painful.
With stem cell donation from the blood, there is very little pain involved. It is very similar to donating blood platelets. The main difference is that for a few days before the donation, donors need to take an injection called filgrastim (Neupogen®), which stimulates the bone marrow to produce extra blood-forming stem cells. They may experience some bone pain or a low-grade fever while taking filgrastim, but the side effects usually are not severe and go away after the donation process is complete.
Bone marrow donation, the less common form of donation, is a surgical procedure done in an operating room. Donors are given general anesthesia so they don’t feel any pain as the bone marrow is removed, or aspirated, from both sides of their pelvis.
“The procedure takes an hour or two, and usually donors can go home within a few hours of waking up,” Dr. Dahi says. “They may have some pelvic and hip pain, as well as some bruising, for a few days, but most donors can immediately go back to their regular activities. The achiness can generally be controlled with over-the-counter pain medications.”
Back to top Arrow (up) icon.
Myth 3: Stem cell donation is inconvenient.
Leading up to the time of the stem cell donation, most people are able to give themselves injections of filgrastim at home, so they don’t need to go to the doctor every day.
On the day of the donation, the donor is hooked up to what is called an apheresis machine. The blood is collected from one arm, sent through a machine that removes the stem cells, and returned to the other arm. Donors can read or watch movies during the donation process.
Dr. Dahi says the process takes three to four hours, and the donor may need to return a second day, depending on how many cells are retrieved.
In the cases of both bone marrow and blood stem cell donation, the donor cells can be retrieved at a local hospital or blood donor room and shipped to where they are needed. The donor and recipient may live in different states, or even in different countries.
Back to top Arrow (up) icon.
Myth 4: Most patients can find a stem cell donor in their own family, so there’s no reason to join the registry.
The process by which the donor and recipient are matched is called HLA (human leukocyte antigen) typing. It’s not related to blood type but instead has to do with the immune proteins that we all inherit at birth from both of our parents. “The immune system uses these proteins to understand which cells belong to your body and which do not,” Dr. Dahi explains. “An optimal match means that eight out of eight markers are the same.”
According to Dr. Dahi, about one-quarter of patients have a sibling who is a perfect match. This means that about 75% of cancer patients must rely on potential donors from the registry.
Even if a sibling is perfectly matched, there may be medical reasons why they are unable to donate. Medical restrictions include infections such as HIV and hepatitis, autoimmune diseases such as lupus, bleeding problems, and a history of cancer. “It’s important to make sure that the process is safe for both the donor and the patient,” she says.
Back to top Arrow (up) icon.
Myth 5: There are plenty of people already in the stem cell donor registry, so my contribution isn’t needed.
Not everyone who needs a donor is able to find one. “For members of minority groups, there can be major problems finding donors because they tend to be underrepresented in the registry,” Dr. Dahi says. “Different ethnic groups have different HLA types, so a patient’s best chance of finding a donor is someone within their own ethnic group.” It may be even harder for people of mixed ethnic backgrounds to find donors, because their HLA makeup can be more complex.
For patients who are unable to find matched donors, there are other options, including a donation from a family member who is a half-match (called a haploidentical transplant) or using stem cells from donated umbilical cord blood, which don’t require a full match. “We don’t want patients to delay their treatment if they don’t have a perfect match,” she adds, “but it’s still the standard to go with a donor who is a perfect match whenever possible.”
Back to top Arrow (up) icon.
Myth 6: Getting into the stem cell donor registry is a hassle.
Joining the registry is easy. You can go to www.bethematch.org to order a collection kit that will be sent to your house or to find a local drive in your area. Once you get the kit, all it requires is wiping a cotton swab on the inside of your cheek, sealing it in a provided container, and mailing it back.
Because the most successful donors are between the ages of 18 and 44, the National Marrow Donor Program asks that people between the ages of 45 and 60 make a $100 contribution to cover the costs of testing their swab.
Back to top Arrow (up) icon.
Medically reviewed by Joseph H. Antin, MD
Thousands of people who face life-threatening blood diseases, such as leukemia, lymphoma and multiple myeloma, require treatment with a stem cell transplantation (also referred to as a bone marrow transplantation). For many patients, the best treatment approach is an allogeneic transplant, in which healthy stem cells are collected from another person. The stem cell donor is selected based on how well his or her Human Leukocyte Antigen (HLA) markers match that of the patient.
Although a person’s HLA type is inherited from his or her parents, the likelihood of finding an HLA match with a family member is only 25 to 30 percent.
“Most people don’t have matched donors in the family, and if we’re going to provide stem cell transplants to cure these otherwise incurable diseases, we need to have a donor,” says Joseph Antin, MD, chief of the Dana-Farber/Brigham and Women’s Cancer Center Adult Stem Cell Transplantation Program.
You can register as a bone marrow donor through the National Marrow Donor Program (NMDP)’s Be The Match Registry®. You will fill out a health questionnaire and provide a sample of your cheek cells, which are collected through a mouth swab.
Below are five important things to know if you are thinking of becoming a bone marrow donor:
1. What does the stem cell donation process entail?
If a complete donor match is found, the patient’s transplant physician will determine the best way for the donor to provide stem cells—either from bone marrow or from peripheral (circulating) blood stem cells (PBSC). If the matched individual decides to go through with the donation process, he or she will sign an Intent to Donate form.
A bone marrow donation is a surgical procedure that takes place in a hospital operating room. During this 1 ½ to 2-hour process, doctors use needles to withdraw liquid bone marrow from the donor’s hipbone. PBSC donation is a non-surgical procedure, similar to donating platelets, that takes several hours over the course of 1 to 2 days.
2. Are there any side effects?
A bone marrow donor will receive either general or spinal anesthesia during the procedure. Common side effects can include lower back pain, fatigue, stiffness when walking, or bleeding at the collection site. Doctors typically prescribe pain medication after the procedure to ease any discomfort or side effects.
PBSC donors may feel tiredness, headache, muscle aches, and nausea.
3. What are the requirements to donate?
A donor must be in good health and should ideally be between the ages of 18 and 44. Transplant physicians select donors in this age range 90 percent of the time due to evidence of better outcomes for patients.
The NMDP requires individuals to be 18 because they must give informed consent; donating marrow is a voluntary procedure that involves surgery, and is not a lifesaving procedure for the donor.
Learn more about the NMDP’s guidelines.
4. What does it cost to donate?
All medical costs and travel expenses for the donation procedure are covered through the patient’s medical insurance or the NMDP’s Be The Match Registry®.
5. What if I cannot donate?
Individuals who cannot donate their stem cells can still help transplant patients by making a financial donation to Be The Match Registry®, sponsoring the registry membership of a donor between the ages of 18 and 44, or volunteering at a donor drive in their community.
For more information on becoming a stem cell donor, visit Dana-Farber’s Bone Marrow/Stem Cell Donor Services webpage or call 617-632-2561.
SINGAPORE – Indonesian student Narita Nikitina’s life was transformed after her graduation two years ago when she was diagnosed with acute myelogenous leukaemia (AML).
For the Lasalle design graduate, now 24, not just the overseas trip that she had planned with her friends was at stake, but also her survival.
After her initial treatment failed, her only chance of survival was through a bone marrow transplant, but none of her family members were suitable donors.
Luckily, she became one of the rare ones who found a match – despite the odds of this being 1 in 20,000.
“I’ve heard that people wait really long or even never get a transplant in time, so I was very happy,” she said.
She cried when asked about how grateful she was towards her donor, Mr Jeth Ng, when she met him for the first time today.
The now 28-year-old assistant brand manager was not expecting a call from the Bone Marrow Donation Programme (BMDP) telling him that he was a match.
In fact, he missed the call and thought the email was spam, but when he eventually got another call, he agreed to go for initial tests.
He hesitated initially, especially because he thought that the only way to donate his bone marrow was a painful extraction from the base of his spine.
Bone marrow harvest is a one-hour surgical procedure that will take place under general anaesthesia, during which liquid marrow is collected from the back of the donor’s pelvic bones.
But the BMDP told Mr Ng about another method called peripheral blood stem cell donation, which is like an extended blood donation process. Donors have to get injections once daily for four consecutive days prior to the donation, then sit in for a five to seven hours process where blood is removed, then passed through a machine where the stem cells are separated and collected, before returning to the donor.
Mr Ng agreed to donating his bone marrow through the second method.
He recalled: “The only discomfort is a slight soreness in the bones before the donation because of the injection that makes you produce more bone marrow. It just feels a bit like post-exercise soreness.”
He was able to return to work after one day of rest, and even went for an eight-day hiking trip a month later in Nepal.
The myth that bone marrow donation has long-lasting effects on the donor needs to be dispelled, BMDP chief executive Jane Prior said.
“There are many old wives’ tales about bone marrow donation so people are reluctant to donate,” she said.
Currently, 50,000 people are listed in the BMDP registry, and almost 500 donations have been facilitated by BMDP since 1993.
People can sign up to be a bone marrow donor by visiting BMDP, the National University Hospital blood donation centre, Singapore General Hospital or requesting a postal kit at bmdp.org/donors/sign-up/.
Bone marrow transplants can save the lives of people suffering from more than 60 diseas including several types of leukaemia.
The BMDP receives about 50 requests each year.
“Signing up as a bone marrow donor and committing to donate can make the biggest difference in the world for a patient,” said Ms Nikitina.
This article is from the archive of our partner .
The natural question following the news that California’s 9th Circuit Court of Appeals had ruled that bone marrow sales weren’t a major federal crime was, what’s the bone marrow market like? According to a lawyer in the case, the price for your precious, precious marrow can reach $3,000. But don’t quit your job just yet: There’s about a 1-in-540 chance you’ll actually get the opportunity to donate. As it turns out, this is not a legitimate moneymaking scheme because of the difficulty in finding the right genetic match among the more than seven million people currently listed by the National Marrow Donor Program. You probably will be able to get compensated if your name gets called, but you’d have a better chance of winning most California scratchers.
The case came in the form of a lawsuit from Maine mother Doreen Flynn, whose three daughters suffer from Fanconi anemia, the Los Angeles Times reported. A site called Moremarrowdonors.org wanted to offer “$3,000 scholarships or housing payments to attract new registrants to the National Marrow Donor Program,” according to the Times, but until Thursday marrow donations were prohibited under the 1984 National Organ Transplant Act. Flynn and her legal team from the libertarian Institute for Justice successfully argued that since the body replenishes marrow the way it does blood, selling it wasn’t the same as, say, selling a kidney. The Times reports that the federal government had banned marrow sales because of the “painful and risky” process once required to extract the stuff.
In the last 20 years, though, medical advances have brought about a less intrusive method by which the life-saving marrow stem cells are harvested from a donor’s bloodstream in much the same way as blood is drawn at a blood bank. The new process, known as apheresis, filters out excess marrow stem cells that circulate in the bloodstream, as opposed to the surgical extraction method, known as aspiration, which inserts a large needle into the hip bone and siphons out the cells.
But the process still requires a time commitment, said Jeff Rowes, the lead lawyer for Flynn. Between a physical exam to make sure the donor is healthy enough to give, a series of preparatory injections that encourage marrow creation but can make the subject feel ill, a six-hour or so procedure to actually donate the bone marrow, and a few days’ recovery time, being a donor is not an easy job. “What you’re doing is paying for the person’s time,” Rowes said. “Something like a mortgage payment for a month, or a housing allowance, or a $2,000 or $3,000 scholarship,” he said, would encourage more people to agree to donate if they were ever called. Rowes said there was currently no way to get cash for a marrow donation, largely because the only outfit offering the compensation was Moremarrowdonors.org. “The infrastructure doesn’t exist right now. That is something that will have to pop up,” he said.