What is bone marrow and why is it needed?
Bone marrow is the spongy tissue found inside certain bones, such as the pelvis and thigh bones. It is a vital factory for producing the body's blood-forming stem cells, which develop into red blood cells, white blood cells, and platelets. When someone has a disease like leukemia, lymphoma, or sickle cell anemia, their bone marrow may not produce healthy blood cells. A bone marrow transplant replaces the diseased cells with healthy, donated blood stem cells, giving the patient a new chance at life.
The two methods of donating blood stem cells
There are two main ways to donate the blood-forming stem cells needed for a transplant. The type of donation depends on the patient's needs and is determined by the transplant doctor.
Peripheral Blood Stem Cell (PBSC) Donation
- The Procedure: This is the most common donation method, accounting for over 90% of all stem cell donations. It is a non-surgical process similar to donating plasma or platelets.
- Before Donation: For five days leading up to the procedure, the donor receives injections of a medication called filgrastim. This drug stimulates the bone marrow to produce extra blood-forming stem cells and release them into the bloodstream.
- During Donation: Blood is drawn from one arm and passed through a machine that separates and collects the stem cells. The remaining blood is then returned to the donor through the other arm. The process typically takes 4 to 8 hours and may be repeated the next day if necessary.
- Recovery: The median recovery time for PBSC donation is one week. Side effects are usually temporary, and related to the medication, including bone pain, headaches, fatigue, or muscle aches.
Surgical Bone Marrow Aspiration
- The Procedure: This method is a surgical procedure performed in a hospital setting. It is often requested for pediatric patients or to reduce the risk of certain complications in the recipient, such as chronic graft-versus-host disease (GVHD).
- During Donation: The donor is given general or regional anesthesia, so no pain is felt during the collection. Using a sterile, hollow needle, doctors withdraw liquid marrow from the back of the pelvic bones.
- Recovery: The procedure typically takes 1 to 2 hours. Donors may experience soreness or aching in the lower back or hips for a few days to a few weeks, similar to a deep bruise. The median recovery time is 20 days, and most donors return to their normal routine within 1 to 7 days.
Comparing PBSC and surgical bone marrow donation
| Feature | Peripheral Blood Stem Cell (PBSC) Donation | Surgical Bone Marrow Aspiration |
|---|---|---|
| Procedure Type | Non-surgical, outpatient procedure | Surgical procedure, performed in a hospital |
| Anesthesia Used | None, but donor receives daily injections of a growth factor | General or regional anesthesia |
| Donation Site | Bloodstream, collected from veins in the arms | Liquid marrow from the back of the pelvic bones |
| Recovery Time | Median of 7 days | Median of 20 days, but back to routine within 1-7 days |
| Common Side Effects | Headaches, bone or muscle pain, fatigue from injections | Back or hip soreness, fatigue |
| Use Case | Most common donation method, for most patients | Often preferred for pediatric patients or to reduce GVHD risk |
Donor safety and body replenishment
Regardless of the method, the human body is designed to recover from the donation. The amount of marrow or stem cells collected represents a small portion of the body's total supply.
- The donated cells are naturally replaced by the donor's body within a few weeks.
- Rigorous health screening and eligibility guidelines are in place to ensure the safety of the donor.
- Organizations like the National Marrow Donor Program (NMDP) provide extensive support and medical insurance coverage for donors throughout the process.
- Serious complications are extremely rare, occurring in less than 1% of cases. The most significant risks are typically associated with anesthesia, which are similar to any other surgical procedure.
Can you donate bone marrow more than once?
In rare cases, a donor may be asked to donate a second time for the same patient, such as if the initial transplant was not successful. This is not a common occurrence. The ability to donate again is dependent on the donor's health, eligibility, and the time elapsed since the last donation. DKMS, an international donor center, notes that a second donation is usually smaller than the first and that they handle the logistics.
Conclusion
The answer to the question "can a person donate bone marrow and still live?" is a resounding yes. Thanks to advanced medical techniques and the body's natural regenerative abilities, bone marrow and stem cell donation is a safe and well-managed procedure. The process, while involving some temporary side effects and recovery time, carries very low risks of long-term problems for the donor. Donors can feel confident that they are providing a life-saving gift while their own body quickly restores its supply. By educating ourselves on the facts, we can dispel old myths and encourage more people to consider this incredible act of generosity. For more information, please visit the NMDP website.
