From OncoLog, June 2007, Vol. 52, No. 6

House Call: Save a Life by Donating Stem Cells

Stem cell transplantation—also called bone marrow transplantation—is a potentially life-saving treatment for patients with leukemia, lymphoma, and other diseases. Many patients, however, do not receive needed therapy because they cannot find a suitable donor. More donors are urgently needed to increase patients’ chances of finding a match.

Q: What is a stem cell transplant?

All blood cells in the human body come from stem cells in the bone marrow, which is the pulpy tissue inside certain bones. Stem cells mature into red blood cells, white blood cells, and platelets—all of which have important functions. If the bone marrow is damaged, it cannot make blood cells properly.

Stem cell transplantation “recharges” the bone marrow. Healthy stem cells are taken from a volunteer donor and infused into a patient’s blood. Ideally, the healthy stem cells will flow to the bone marrow cavities and produce more bone marrow and blood cells.

Traditionally, stem cells have been drawn directly from a needle inserted into the bone marrow in the back of the donor’s pelvis. The most common side effects are soreness in the lower back, tiredness, and difficulty walking for several days or longer.

Stem cells can also be collected from the blood. The donor is usually given a drug called filgrastim that releases immature stem cells from the bone marrow into the blood. The cells are then collected using a filtering machine.

Stem cells are also found in the blood of the umbilical cord. They can be collected after the baby is safely delivered and the cord is cut. The procedure does not affect the baby or mother in any way—the umbilical cord would otherwise be thrown away.

Q: How are donors matched to recipients?

Each person is born with a combination of identifying markers, or antigens, found on the surface of his or her body’s cells. These antigens must be matched as closely as possible between a donor and a patient, or serious complications will result. A simple blood or saliva test (HLA typing) determines a person’s antigen combination. Because there are thousands of possible combinations, the chance of finding an exact match for a patient is low—especially if he or she is a member of an ethnic minority group.

Antigens are inherited from a person’s parents, and a patient’s brothers and sisters are the best possibilities for matches. The search for a donor starts there and then expands to more distant relatives. If no match is found among relatives, the patient’s doctor must search in registries of unrelated potential donors. The National Marrow Donor Program (NMDP) runs the largest such registry in the United States. Worldwide, more than 10 million volunteers are registered as potential donors. But despite these high numbers, many patients still cannot find a match.

Q: Who can donate?

To ensure the safety of patients and donors, the NMDP has important guidelines for potential volunteers.

• You must be between 18 and 60 years old with a body weight that is neither too high nor too low.
• Pregnant women can register but cannot donate stem cells until after delivery.
• Having well-controlled high blood pressure, diabetes, or mild asthma is usually allowed, but having severe arthritis, severe asthma (requiring daily steroids), an autoimmune disease, heart disease, or serious spine problems will probably prevent you from registering.
• If you have been diagnosed with HIV, you cannot register. Other sexually transmitted diseases, such as herpes, human papillomavirus, chlamydia, or syphilis, will not prevent you from registering.
• A history of most forms of cancer will prevent you from registering, but you can register if you have been cured of localized basal or squamous cell skin cancer or in situ cervical, breast, or bladder cancer.
• Having ear or body piercings won’t prevent you from joining the registry, as long as the piercings were done under sterile conditions; but if you recently received a tattoo, you may have to wait a year to register.

If you meet their guidelines, your local NMDP center will handle your registration and HLA typing. You may or may not have to pay for your testing, but all medical costs of donation will be covered if you are matched with a recipient.

For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.

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