Donating Stem Cells and Bone Marrow

A stem cell transplant may be used to treat some cancers. These include multiple myeloma, leukemia, and lymphoma.

Stem cell transplants involve a donor. Some people choose to donate stem cells to a loved one who is diagnosed with cancer. Others donate to someone they don't know.

Here's a closer look at the process.

Stem cells are very young cells that haven't developed yet. They eventually turn into the three different types of blood cells: white, red, and platelets.

Most of these cells live in your bone marrow, the spongy center of your bones. This is where they divide and make new blood cells. Once they mature, they leave your bone marrow and enter your bloodstream. A small number of immature stem cells get into your bloodstream, too. These are called peripheral blood stem cells.

Blood cancers like leukemia, multiple myeloma, and lymphoma also start in your blood cells. Doctors may use a stem cell transplant to treat these cancers. They first use very high doses of chemotherapy to kill cancer cells. This treatment also causes your bone marrow to stop making blood cells for a short period of time. Doctors can then transplant stem cells, either from the patient or a donor. These healthy stem cells grow into mature blood cells that work normally and divide into new, cancer-free cells. When cells are used from a donor, they often find and kill cancer cells better than the patient's own immune system.

A close match increases the chances the transplant will work. It also reduces the risk of complications, like the donor's cells attacking the patient's cells.

A doctor may ask immediate family members to take a human leukocyte antigen (HLA) test. It looks at genetic markers on your white blood cells. If they're similar enough to the ones on your loved one's cells, you may be able to be a donor. You don't have to have the same blood type.

The HLA test is very simple and involves either a blood test or a cheek swab. You can do it at your loved one's cancer facility. If you don't live near your loved one, contact the National Marrow Donor Program at 800-MARROW-2 or at https://www.nmdp.org/ to find a donor center near you.

If you're a match, you'll need to sign a consent form. You'll also have to have a medical exam, including blood tests, to make sure you're in good health.

Certain things may prevent you from being a donor. You can't be a bone marrow donor if you:

• Are older than age 60.
• Have certain medical conditions, such as HIV or certain heart or kidney problems.
• Had chemotherapy or radiation therapy for a solid tumor type cancer in the past 5 years.

There are two methods of donation: peripheral blood stem cells (PBSC) or bone marrow. The doctor will choose the one that's best for the person with cancer.

You'll get injections of a granulocyte colony stimulating factor (G-CSFs) medicine, such as filgrastim, for 4 to 5 days before your donation. Filgrastim causes your bone marrow to make and release a lot of stem cells into your blood. It can cause side effects like:

• Bone and muscle pain
• Headaches
• Nausea
• Trouble sleeping
• Mild fevers
• Tiredness

Your doctor may advise medicines to help. Side effects will go away once your injections are done.

On donation day, your blood will be removed through a needle in one arm and passed through a machine that separates out the stem cells. This is called apheresis. The remaining blood is returned to you. Most donations can be made in one session, which can take several hours.

You may feel lightheaded or tingly during the procedure or have chills or muscle cramps. This is because doctors use special medicines to keep your blood from clotting in the machine. The medicines can temporarily lower your calcium levels. You may get calcium supplements. Symptoms will go away once your donation is finished.

You'll feel back to yourself and able to return to your normal activities like school or work within about a week of your donation.

During this procedure, a doctor uses hollow needles to withdraw or aspirate liquid marrow (where stem cells live) from the back of your pelvic bone. You'll get anesthesia, so you won't feel any pain. Usually, about 10% of your marrow—around 2 pints—is collected. The procedure takes a couple hours. Once it's done, you'll have to stay in the hospital for a few hours for observation. After the procedure, you may notice:

• Soreness, bruising, and aching around the back of your hips and low back
• Feelings of tiredness or weakness
• Trouble walking

These symptoms only last for a few days. Your doctor may advise medicines to help. Your doctor will also check your red blood cell levels. If they're low, you may need to take iron supplements for a short time to boost them.

Most people get back to their usual activities within a week. But it can take several weeks before you're completely back to normal. Your body will replace all the stem cells you lost within 4 to 6 weeks.

If you decide to donate stem cells or bone marrow, you can expect to feel some pain and discomfort. But you should also feel proud. Your donation is the biggest gift you could give to a person in need.