Q: What is a bone marrow transplant?
A: A BMT is when bone marrow cells from a healthy person are given to somebody who has a blood condition, such as cancer, that can be treated with healthy bone marrow cells. The donor’s cells can help clear a patient of cancer or other blood related diseases.
Q: What is the difference between a bone marrow transplant and a stem cell transplant?
A: BMT and SCT are often used interchangeably. Bone marrow stem cells can grow a bone marrow and long lived cells that maintain normal bone marrow function for a person’s lifespan. Bone marrow stem cells can be extracted from the bloodstream after giving the donor shots of a stem cell stimulating medication or using a needle to extract the cells from the hip bones.
Q: Will donating my bone marrow harm me?
A: Bone marrow donation is safe, complications are rare and usually minor. If the donor’s bone marrow cells are extracted from the hip, he/she will be under anesthesia. It is a minor surgical procedure. Recovery takes several days due to minor hip pain. If the donor’s cells are collected from the bloodstream, the donor will receive series of stem cell stimulators (ex: neupogen) before the collection date. The collection day procedure is similar to donating blood but takes longer. The procedure will take up to 6 hours and will be completed when the cell concentration is adequate for the donor.
Q: How often do they extract from the hip bone?
A: Typically 10% is from the hip bone and 90% from the bloodstream. It usually depends on the donor’s preference.
Q: What is the recovery time?
A: The recovery time for the hip extraction averages 7 days. A blood collection recovery is about 2-3 days on average.
Q: When can I return to work?
A: The donor can usually return to work in 2-3 days.
Q: I heard that I could donate my umbilical cord blood at birth. Is this true?
A: Yes, if your hospital participates.
Q: Why don’t more hospitals offer the service to donate umbilical cord blood?
A: It is a specialized procedure and the cost to collect, process and store the cord blood is expensive. To make this cost-efficient, cord blood banks are usually at hospitals with very large numbers of births, generally in urban areas.
Q: Will it cost me to donate?
A: No, the patient’s insurance will cover the expenses.
Q: Who/How can I donate?
A: Any adult between the ages of 18-60 that are in good health. They can not donate if they have a transmissible disease. The donor can join the registry at www.bethematch.org after a personal medical history form is approved.
Q: How does the bone marrow work to help the body?
A: Through the source of oxygen carrying red blood cells, blood clot forming cells, and the entire immune system.
Q: How long does it take to work?
A: Once the BMT is given, the cells will begin to take residence in the bone marrow space with in hours. It will take about two weeks for the cells to grow and the recovery time is weeks to months.
Q: How long does it take to donate/receive?
A: For the donor, it is a multi-step process: first you start off with a cheek swab and then you will be added to the registry. If you are found to be a preliminary match, you will receive a call to let you know that you’re a possible match. From there, if you are willing and able, the actual donation takes a few hours.
For the recipient: The process takes a few hours and the majority of the time is recovery.
Q: How do they determine a match?
A: If the cheek swab DNA matches the recipients DNA, they will proceed with further testing.
Q: What is the percentage of success?
A: There is a 90+% that the cells will engraft. From there, it is dependent on the indication of the transplant and how aggressive the disease is. If a patient (any age) makes it past the first year post-transplant, they have a 50+% of not relapsing.
Q: How much does it cost? How do most people pay for it?
A: The cost is $80,000-$250,000 for the actual procedure. There are other hospital expenses incurred. Most people pay through insurance, Medicaid, and/or charity funds.
Q: Are there any side effects?
A: Generally side effects from donation are mild. If you are asked to consider donation, you will meet with a medical team to go over all the risks and explain the procedure in detail.
Q: Does the donor have to be on any special diet or medicine before they donate?
A: Donors do not need to be a special diet. If they are donating stem cells from the blood stream, the donor will be given shots of a stem cell stimulating medication. These shots are usually given at the donor’s home.
Q: Can a person donate or receive marrow more than once in a lifetime?
A: Yes, but this is not common.
John Levine, MD
University of Michigan
Bone Marrow Transplant