1. WHO CAN
BE AN UNRELATED MARROW DONOR?
Potential unrelated volunteer donors must be between 18 years
old and 60 years old to meet the requirements for marrow donation.
Individuals selected as unrelated marrow donors must also
ultimately pass a thorough physical examination. Donors are
selected on the basis of their HLA types and extensive compatibility
testing.
2. WHAT IS HLA?
HLA (Human Leukocyte Antigens) are markers on the surface
of white blood cells. HLA forms the basis for recognizing
and rejecting foreign tissues. Matching marrow recipients
and their donors for their HLA type has been shown to greatly
increase the likelihood of a successful transplant. HLA genes
are inherited. There are over 20,000 marrow types in the general
population. Thus, the greatest chance for finding a matched
marrow donor exists within the patient's own family. Unfortunately,
only about 25 percent of patients needing a transplant have
a matched family member. So, the odds of any two unrelated
individuals matching are about one in 20,000. That is why
it is crucial to have on file as many potential donors (of
all different races and ethnic background) as possible.
3. WHAT IS A
BUCCAL SWAB AND HOW IS IT USED?
Buccal Swabs are cotton-tipped applicators. They look like
cotton swabs used in personal care but have a longer stem
and only one cotton tip. Buccal swabs are used to collect
cheek cells from inside your mouth. These cheek cells
provide DNA for HLA testing, which is used to determine a
match between a donor and patient.
4. WHAT DO I
HAVE TO DO TO COLLECT THE SAMPLE?
Brush a swab against the inside of your cheek for
approximately 10 seconds using the same force used to brush
your teeth.
5. DOES THIS MEAN I WILL NOT HAVE TO
GIVE A BLOOD SAMPLE?
At the time of your
registration, you will not have to give a blood sample.
But, if you do match a patient, you will be asked to provide
blood samples for additional testing.
6.WHAT HAPPENS
WHEN A PERSON AGREES TO BE A POTENTIAL MARROW DONOR?
HLA typing will be performed on buccal swabs containing
cheek cells obtained during
a group testing session or by the individual walking into
one of many draw sites around the country. This information
is then input into a nationally recognized registry database
and becomes part of their confidential computerized file.
If a patient needs a marrow transplant from an unrelated donor,
the Registry conducts a computerized search to identify donors
with the same HLA type as the patient. The registry will then
contact the potential donor to find out if they are interested
in pursuing the second phase of testing. Arrangements are
then made to obtain additional blood samples to determine
if full compatibility exists between donor and patient.
7. IF IT'S A
MATCH, WHAT NEXT?
If buccal swab tests determine that the unrelated donor is compatible,
he/she is asked to make a final commitment. Prior to the donor
making his decision, the donor is provided an extensive explanation
of the marrow donation procedure and a complete physical examination
is performed to ensure that the prospective donor is medically
eligible to donate. Only after the donor has made a final
decision to donate and has passed the physical exam are arrangements
made for the actual collection.
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8. WHAT IS THE
PROCEDURE FOR DONATING?
If all tests confirm that an individual is the best possible
donor, an information session is scheduled to educate the
potential donor on the two types of donation processes (described
below). A complete health check is done to ensure there is
no danger to either the recipient or the donor.
Marrow donation:
Marrow is removed from the bones on one or both sides of the
upper hip area using a special syringe. The procedure is performed
by an approved collection center, usually under light general
anesthesia. The entire donation process lasts about one hour.
The donor usually spends a night in the hospital for observation.
Approximately 3 to 5 percent of your marrow is extracted.
The body naturally replenishes the donated marrow in a week
to 10 days, and it is not "missed" during that time.
Peripheral Blood
Stem Cell (PBSC): For a PBSC
donation, you will receive daily injections of filgrastim
for 4 or 5 consecutive days. Filgrastim is a blood stem cell
growth factor that increases the number of blood stem cells
released from your marrow into your blood stream so they can
be collected through an aphaeresis procedure. In this process
the donor's blood is removed through a sterile needle placed
in a vein in one arm, and passed through an aphaeresis machine
that separates out the stem cells; the remaining blood (minus
the stem cells) is returned to the donor through a sterile
needle in the other arm. Unlike marrow donation, PBSC donation
does not require anesthesia, which is the most significant
risk of marrow donation. PBSC donors can experience bone pain
prior to the donation procedure as a result of receiving filgrastim.
These effects diminish over one to two days after the last
dose of filgrastim has been given.
9. WHAT ARE
THE RISKS?
More than 20,000 transplants have been performed in the United
States. To date there have been no reported long term adverse
effects to any donor. Only healthy candidates are accepted
and there are existing medical standards approved by the National
Heart, Lung and Blood Institute to protect the donor. Donors
typically experience mild discomfort and tenderness in the
area where the marrow was collected, but this discomfort usually
lasts just a few days and does not generally prevent normal
activity.
10. HOW LONG
DOES IT TAKE FOR A MARROW DONOR TO RESUME NORMAL ACTIVITIES?
Most donors return to their normal activities, including work,
within a day or two.
At most, donors have reported
feeling slight aches in their backs a week after the
procedure.
11. WHO COVERS
THE COSTS?
There is no cost to the donor. Medical examinations and hospital
expenses are paid by the recipient.
12. SHOULD I SIGN UP AND BE TESTED
TO BECOME A POTENTIAL MARROW DONOR?
Deciding to become a potential marrow donor requires careful
deliberation. We hope we have answered many of your questions.
The next step is up to you. Thank you for taking the time
to consider this very important step.
