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Patient education: Donating bone marrow or blood stem cells (The Basics)

Patient education: Donating bone marrow or blood stem cells (The Basics)

What are stem cells? — Blood or bone marrow stem cells are special cells that can become many different types of blood cells. They are found in the blood and in the bone marrow (the tissue in the center of certain bones).

A stem cell transplant is when healthy stem cells are put into a person's body to replace stem cells that are diseased or damaged. This is also called a "hematopoietic stem cell transplant" or "bone marrow transplant."

Why might someone need a stem cell transplant? — A person might have a stem cell transplant to help treat a cancer, such as leukemia or lymphoma, or another medical condition. The healthy stem cells can come from a few different sources:

The person's own body

A relative, such as a brother or sister

A person who is not related

Blood from a newborn baby's umbilical cord

A person who gives stem cells to another person is called a "donor."

What does it mean to be a "match"? — To donate stem cells to another person, your blood needs to closely match theirs. To check this, doctors can do special tests to look at certain proteins on your body's cells. This is called "HLA typing." HLA type is not the same as blood type (A, B, AB, or O).

Donated stem cells can come from:

A sibling – When a person needs a stem cell transplant, siblings (brothers and sisters) might be tested to find out if any of them is a "match." There is about a 1 in 4 chance that a brother or sister will be a match for HLA type. If there is a match, a sibling donor is usually the best option. That's because siblings share similar genes, so the stem cells are more likely to work well with the body of the person who gets them. If tests show that a sibling is an HLA match, the person is called a "matched related donor."

An unrelated person – If no sibling is a good match, it is sometimes possible to find a donor who is not related to the person. This is often done by searching registries, which are lists of people all over the world who have volunteered to donate stem cells. The chances of finding a match from a registry partly depend on the person's race and background. When a person who is not a relative is an HLA match, they are called a "matched unrelated donor."

A parent or child – Sometimes, a person's parent or child can donate stem cells for transplant. When this happens, it is called a "haploidentical" transplant. With a parent or child donor, only half of the genes will be a good match, while siblings share more similar genes.

Umbilical cord blood from a newborn baby – In some cases, stem cells from a newborn baby's umbilical cord can be used. This is called an "umbilical cord blood transplant." Not all centers perform haploidentical transplants or umbilical cord transplants.

Are there other requirements for donating stem cells? — Yes. If you are found to be a "match" for someone who needs stem cells, that's the first step. But there are other requirements, too.

To donate stem cells, you must be in generally good health. You will have a physical exam and blood tests before you are allowed to donate. You will also need to answer questions about your health and behavior. These usually include questions about:

Any medicines you take, or took in the past

Any recent vaccines that you have gotten

Whether you have had certain diseases

Countries you have lived in or traveled to

Sex partners you have had

Drug use

Past pregnancies

You will get information about the donation procedure and risks. You will also be asked to sign forms saying that you agree to be a donor. It's important that you are making the choice to be a donor for yourself, and that no one is pressuring you to do it.

What is the procedure like? — It depends on how your stem cells are collected. They can be taken from either the bone marrow or the blood. Your doctor will talk to you about each option, and help you decide which is best for your situation.

Blood collection – If you are donating stem cells from your blood, a needle will be inserted into a vein in each of your arms. Your blood will be taken from 1 arm and run through a special machine that collects the stem cells. After the stem cells are taken out, the rest of the blood goes back into your body through the other arm. This usually takes a few hours. Most donors only need to do this once for enough stem cells to be collected, but some people need to go back a second time.

You will need to take a medicine to help your blood produce extra stem cells for several days before the collection. This medicine comes in a shot that can be given at the doctor's office, or you might give yourself the shot at home each day. It causes temporary muscle or bone pain in most people. You can take acetaminophen (brand name: Tylenol) to help with this pain.

Bone marrow collection – If you are donating bone marrow, right before the procedure, you will be given medicine (called anesthesia). The medicine prevents you from feeling pain. A doctor will insert a special needle into the back of your hip bone, and take out some of your bone marrow. The doctor will need to insert the needle more than once to get enough bone marrow. After the procedure, the area where the needle went in will be covered with a bandage.

If you are a bone marrow donor, you will need to avoid alcohol for about 2 weeks before the procedure. You will also be asked to avoid medicines known as "nonsteroidal antiinflammatory drugs," or NSAIDs, for 24 hours before. These medicines include ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve). Some people need to take iron pills before and after donating bone marrow.

What are the risks to me? — Both ways of donating stem cells involve some pain. For bone marrow donation, you are more likely to have pain after the procedure, in the hip area where the needles went in. There are also risks that go along with any surgery, including infection or problems with anesthesia. For blood stem cell donation, you are more likely to have pain in the days before the procedure. This is related to the medicine you take to help your body make more stem cells.

Most people who donate stem cells feel good about being able to help someone. You might have some stress, especially if you are donating to a family member. Remember that by donating stem cells, you are improving someone's chances at a healthy life. A stem cell transplant does not always lead to recovery, and it's not your fault if the person does not get better.

What will my recovery be like? — If you donated bone marrow, you will likely have some pain after the procedure. You might also be more tired than usual. But you should feel back to normal in a month or so. You should avoid heavy lifting and intense exercise for about 6 weeks to allow your body to heal.

If you donated blood stem cells, you might feel fine right after the procedure. Your doctor might tell you to rest for a few days, but you should be able to get back to normal activities soon. No matter which way your stem cells were collected, your body will create more to replace the ones that were removed. You will be back to having the normal amount of stem cells within a few weeks or months.

More on this topic

Patient education: Autologous bone marrow transplant (The Basics)
Patient education: Bone marrow aspiration and biopsy (The Basics)

Patient education: Hematopoietic cell transplantation (bone marrow transplantation) (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
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