In January, the National Marrow Donor Program (NMDP) celebrated its 35,000th bone marrow transplant, marking an impressive milestone in the nonprofit organization's 21-year history. Colleen Chapleau, director for the Iowa Marrow Donor Program and the Adult Blood and Marrow Transplant Program at University of Iowa Hospitals and Clinics, talks about becoming a bone marrow donor:
Who can be a bone marrow donor?
Anyone in good health between the ages of 18 and 60.
When someone donates blood they schedule an appointment. How does someone donate bone marrow? What are the steps involved?
The first steps down that path are to become educated on what is involved in donation, and then make the decision to become a part of the National Registry. The registration is really a simple process. It requires the completion of forms and signing a consent. The consent gives permission to be tissue typed and have that typing listed in the National Registry. When the paperwork is complete, the volunteer swabs the inside of the mouth and those swabs are sent to the National Marrow Donor Program for tissue typing.
When someone joins the National Donor Registry, how is that information shared with other states and countries?
The National Registry is a single point of access to over 13 million registered donors living in the U.S. and abroad. So it's really a global program helping patients worldwide and every day the National Registry searches for potential matches. Right now, at the University of Iowa Hospitals and Clinics, we have 16 people with active donor searches, and that means there are 16 children and adults and their families who are hoping that someone who doesn't know them but who happens to share their tissue type is listed in the National Registry.
Once you are matched with someone in need of a bone marrow transplant, what happens?
You're contacted by staff in our Iowa Marrow Donor Program and informed you may match a specific patient. We ask if you're willing to have additional blood work done to determine if you are indeed that perfect match. We make arrangements for blood to be drawn and sent to a lab for more specific testing.
Of all the people who register, not many are called for this additional testing, and even at this point, someone has less than 20 percent chance of being asked to donate. Of all the people who register with our program, less than two percent are actually asked to donate.
If the testing comes back that the person is a match, we ask them to come to University of Iowa Hospitals and Clinics for additional information. We want to be sure they're informed about what's involved. We ask them to have a physical examination; and this is done at no cost to them. If they live a distance from our hospital, we'll reimburse for travel costs.
They'll either be asked to donate bone marrow or peripheral blood stem cells. The decision on which product is made by the patient's physician and it's made to give the patient the best chance to do well in transplant.
If someone is asked to donate marrow, it's a surgical procedure. It's done as an outpatient, and the donor receives anesthesia while the liquid marrow is removed from the hipbone using a needle.
If the donor is asked to donate peripheral blood stem cells, the donation takes place in an apheresis center and it's similar to donating platelets. The difference is that the donor will receive a daily injection of a drug called filgrastim for five days and that's done to increase the number of blood forming cells in the blood stream.
When someone donates bone marrow, does the body replace that marrow?
Yes, it does. Whether they donate marrow or stem cells, within about two weeks after the donation, the body has completely replaced what they've donated.
How much time elapses between the donation of bone marrow and the actual bone marrow transplant to the matched patient?
Because this is an international program, the donor donates here at University of Iowa Hospitals and Clinics and their healthy cells are transported by a trained courier to the transplant center where the patient has already begun their therapy. Most patients receive their new cells within 24 hours of the donation.
What is the hope a bone marrow transplant will do for the person with cancer?
It really is their second chance at life. The children and adults who need to have a transplant are battling diseases such as leukemia and lymphoma and because the disease is especially nasty, for many of them, a bone marrow transplant is really their only chance.
This donation is much more involved than a blood donation. What is the reaction from donors when they go through this process and become a bone marrow donor?
Not often in our lifetime are we given a chance to do something so significant and wonderful for someone in need. Many donors have told us that the experience of donating is not physical—it's actually an emotional experience because they realize that their donation has given someone who is battling a deadly disease a chance to survive. And they realize that they actually have become the answer to a family's prayers. |
