Saving Lives with Bone Marrow Donations and Transplants

By Sara Thompson

When Louisville native Cheryl Brawner went to the doctor to see about a minor infection last November, she didn't expect to be told she has acute myeloid leukemia (AML), a cancer that causes bone marrow to produce abnormal white blood cells, red blood cells, or platelets. “My husband and I were shocked,” says Brawner, an avid cyclist who admits to never having been sick in her life.

Brawner was treated with several rounds of chemotherapy and was given a clear bill of health. But when the cancer returned in July 2006, the decision was made to proceed with a bone marrow transplant. Brawner will travel to Seattle 's Fred Hutchinson Cancer Research Center to seek further treatment. “This is an indiscriminate disease; it can strike anybody,” she says, “and people need to understand that.”

Each year more than 35,000 children and adults in the US are diagnosed with diseases for which a marrow or blood cell transplant could be a cure, according to the National Marrow Donor Program (NMDP). More than 5.5 million people have volunteered to donate marrow or blood cells to any patient, anywhere in the world, through the NMDP.

The National Marrow Donor Program (NMDP) is a congressionally authorized computerized databank of potential marrow donors. The NMDP describes marrow as tissue found in the large bones of the body that produces vital blood components, including white cells, which fight infection, red cells, which carry oxygen, and platelets. Diseases that attack your marrow, such as cancer, may eliminate your body's ability to fight infections. Radiation and chemotherapy have been used to combat these illnesses, but those options seriously damage the body. Marrow transplants are less debilitating and give patients a second chance of a healthy life.

The NMDP has an extensive website (www.marrow.org) that features information for physicians, donors, and recipients. You can request information and a test packet, update your address and health status, get information, sign up for a free newsletter, and more.

In Louisville , the J. Graham Brown Cancer Center's NMDP Recruiter, R.N. Ashley Morrill, is also available for questions or packet requests. She can be reached at 502-852-3154.

All types of tissue are needed, but not everyone can donate bone marrow. You must be between the ages of 18 and 60 and in good health. You must also be the appropriate weight for your height and age. People with certain health problems such as immune disorders and blood diseases are not eligible to become donors.

It can take years before a potential match is found, so donors are encouraged to seriously consider this as a long-term commitment. Sharon Coke, Brown Cancer Center 's Donor Center Coordinator, talks about the frustrations involved with the program. “It's heartbreaking to finally find a match, to tell that recipient, ‘Yes, we have a match!' and then finding out that donor doesn't want to do it anymore, or we can't find them at all.” It's important to keep the donor center posted on your location and desire to remain on the donor list. You can choose to remove yourself from the list at any time.

To join the registry, you need an information packet which includes an easy do-it-yourself test. Using the provided materials, you will sweep the inside of your cheek with a cotton swab and mail it to the NMDP registry center with a $25 check that covers the cost of tissue sampling processing. Your swab is processed within the next few weeks, and your name is entered into a national database of marrow donors. You can ask to see if you are a potential match with a specific person, but your name will remain in the database for other potential matches.

If you are selected as a potential match for a bone marrow recipient, you will give some blood for further testing. Once you are a confirmed match, there are two common low-risk ways to collect the marrow or stem cells, depending on the recipient's physician's choice. The recipient's health insurance covers your costs.

One way to collect bone marrow is through a marrow harvest. According to the NMDP information, marrow donation is a surgical procedure performed under general anesthesia. Doctors use needles to withdraw marrow from the back of your pelvic bones. Donors report feeling some soreness in the lower back for a few days after the collection, but most people return to a normal routine in a few days. Your body replaces your marrow completely within four to six weeks.

A second method of collection is a Peripheral (circulating) Blood Stem Cell collection (PBSC) collection. This method removes stem cells circulating in your blood through apheresis, a process also used to collect platelets. According to NMDP, patients receive daily injections of a drug called Filgrastim for five days before the collection to increase the number of blood-forming stem cells in the bloodstream. Blood is removed through a needle in one arm and passed through a machine that separates out the blood-forming cells then returns remaining blood to you through a second needle. Patients report side effects such as headaches or bone or muscle aches for several days before collection, but these effects disappear shortly after the collection.

The third resource for stem cells is the umbilical cord, which is usually thrown away after birth. Cord blood helps rebuild the recipient patient's blood cell producing system with blood-forming cells. Cord blood is collected from the umbilical cord after a baby is born and does not change the birth process at all. There is no charge for this safe and confidential donation.

The process of bone marrow collection may not sound very attractive, but consider the fact that being a marrow donor saves lives. You might not know Cheryl Brawner and you might not be a match for her, but you could be a match for someone else who needs your help.