HealthNews Salutes: The National Marrow Donor Program

Did you know that over 6,000 people daily search for a bone marrow donor literally as a matter of life or death? For many patients with life-threatening diseases such as leukemia and lymphoma, a bone marrow transplant is their only real hope of survival and the best possible chance for a cure.

The good news is that you can help save lives by joining The National Marrow Donor Program (NMDP) Registry. This organization strives to offer hope and is committed to delivering a possible cure to all patients in need of help.

For a transplant to be successful it is imperative for the tissue type of a bone marrow donor to match that of a patient as closely as possible. Specialized tests are performed to determine if a patient and bone marrow donor are optimally matched. Consideration of race and ethnicity are very significant in the search for a tissue match because tissue types are inherited. The more donors available within the NMDP Registry who come from various racial and ethnic backgrounds the greater the chance that a patient will find the tissue match they so desperately need. In fact, there are several urgently needed donors from several specific communities including Black and African American, American Indian and Alaska Native, Asian, Native Hawaiian (and other Pacific Islanders), Hispanic and Latino as well as multiple race individuals.

The NMDP Registry is in real need of new donors to join the Registry as well as for expectant parents to choose to donate cord blood. Just as with bone marrow, cord blood contains an abundance of the blood-forming cells utilized in transplants for leukemia and lymphoma patients as well as many other patients who suffer from a life-threatening disease. A patient’s physician will make the appropriate decision regarding the best source of blood-forming cells necessary for a successful transplant.

Whenever possible, a patient’s own cells are collected from the patient’s blood stream prior to a transplant. However, if the best option is to use donated cells, a doctor will search for a donor or a cord blood unit that has a tissue type closely matching that of the patient. Generally, a patient’s best chance for a match is with a sibling, yet 7 out of 10 people will not have a suitable match within their family, forcing them to look for other possible donors.

Although joining the NMDP Registry is a life-giving opportunity, one needs to realize the importance of being committed to this decision. It is highly recommended that you discuss your decision with your family and/or friends as you may find yourself in need of their support if you are ever discovered to be a match. In addition, the commitment should not be taken lightly. A last minute decision not to not donate after having registered as a donor could be life-threatening to a patient in need if you are contacted as a match. Give serious consideration before making a decision to become a donor.

Anyone between the ages of 18 and 60 can potentially join the NMDP Registry. The lower age limit, or course, is based on the legal age of consent and the upper age limit is due to a slight increase in the risk for side effects from anesthesia.

Potential donors with certain medical conditions, such as HIV (AIDS), severe arthritis, certain spinal issues or certain autoimmune disorders may not register with the NMDP. Organ transplant recipients will also be unable to register.

If you have a history of pre-cancerous cells, or certain stage zero cancers you will be able to register. However, all other forms of cancer are unacceptable. If you have diabetes and require insulin or injected medications or you have diabetes-related serious health issues such as kidney, heart or eye disease, you will not be allowed to register.

Other conditions that may prevent registration are having a serious bleeding problem, a serious breathing problem such as chronic obstructive pulmonary disease (COPD), heart disease, hepatitis B or C, serious or chronic kidney problems, Lyme disease, or having active pulmonary tuberculosis (TB) within 2 years of potential registration.

Persons with serious or life-threatening allergies to medications or latex as well as volunteers with Asthma will need to be carefully evaluated before being allowed to join the NMDP Registry. And, you may not be allowed to register if your Body Mass Index (BMI) would present a risk to your safety. Visit the NMDP web site at http://www.marrow.org/ for full details on the criteria to become a donor.

You can also donate your baby’s umbilical cord blood to a public bank for free. Umbilical cord blood is rich with blood-forming cells (not embryonic stem cells) that are no longer needed by your baby after delivery. Before your 34th week of pregnancy discuss your decision to donate umbilical cord blood with your doctor and determine if your hospital collects donations of public cord blood. See the NMDP Registry web site to obtain a full listing of collection sites as well as how to become a donor. You can also view the expectant mother eligibility guidelines online.

Once you have made the decision to join the Registry and you meet the criteria as a donor, you will need to complete a short health questionnaire and sign a form stating that you understand what being on the Registry means. After this, you will be asked to give a small blood sample or swab of cheek cells for testing to determine your tissue type for addition to the registry. Beyond these simple steps, you need to remain committed and to be available. Doctors continuously search the Registry for donor matches for patients. You will be contacted if you are a match and further testing will be scheduled if you agree to participate in the donation process.

You will also be invited to attend a session for further education regarding the donation process as well as risks and side effects. You are encouraged to bring a friend or relative to the session. You will be told whether doctor has requested a donation of bone marrow cells or cells from your circulating blood (known as a PBSC donation). You can then decide whether or not you wish to donate. If you choose to donate, a physical exam will be performed to determine if any special risks exist for you or the transplant patient.

For bone marrow donations a surgical procedure is performed. You will receive anesthesia after which a doctor will use special hollow needles to extract liquid marrow from the back of your pelvic bones. Donors often receive a transfusion of their own blood that has been previously donated.

Although the majority of donors are back to normal in only a few days, expect to experience some soreness in the lower back for a few days or so. A donor’s bone marrow is totally replaced within four to six weeks.

PBSC donation takes place at an apheresis center. Apheresis is an automated blood collection technology that allows a donor to give specific blood components. You will receive daily injections of a drug known as filgrastim for five days prior to the collection, for the purpose of increasing the number of blood-forming cells in your bloodstream. During the collection, a sterile needle in one arm is used to remove your blood, which is then passed through a machine that separates out the blood-forming cells. Side effects include headache or bone or muscle aches for several days prior to collection, from the filgrastim injections. These effects subside shortly after the collection process.

After your donation, the NMDP Registry will first follow up with you until you are able to resume normal activity and then will contact you annually for long-term follow up.

More than 350 patients monthly find a matching donor or cord blood unit and are able to receive a transplant that is made possible through the NMDP Registry. Approximately 20 percent of these patients receive cord blood that has been donated to a public cord blood bank. Together we can make a difference and save more lives. Won’t you consider being a life-saving donor?