Bone Marrow Transplantation

Who can become a stem cell donor?
Anyone aged 18 to 50 without a chronic illness. Your blood group does not matter.

I've given blood sample* in the past. Do I need to have another test?
No. A potential stem cell donor needs to give blood only once. The results are added to the Israeli register of potential donors and to the international register.

The following questions are answered by Dr. Julia Volchek, a haematologist from Tel Ha Shomer hospital.

What is bone marrow transplant? Why is it called stem cell transplant these days?

The name "bone marrow transplant" is a relict. For the last 10 years we don't actually transplant bone marrow, but peripheral stem cells instead. Everything is based on the peripheral blood – regular blood taken from a vein. For the donor the procedure is like a regular blood test*. The sample is sent to a genetic laboratory where it's compared to the sample taken from the patient who requires a donor. If there is a complete match and the potential donor gives his consent, the transplant can be performed. The selected donor receives an agent that stimulates stem sells transition from the bone marrow into peripheral blood. This is a subcutaneous injection that the donor needs to receive for four days. Generally speaking, this agent does not cause medical problems. It's frequently prescribed when a patient needs his leukocytes count raised. Possible side effects are slight queasiness, back pain, slightly raised temperature (up to 37.5 C / 99.5 F). These all go away once the injections are finished and collection is completed.

Afterwards the donor visits a hospital where he is hooked to a special device that's similar to a dialysis machine. The blood is taken from vein and circulated through that device. The stem cells are extracted from the blood which then returns to the donor through the other hand. This circulation lasts for several hours. It does not require anaesthesia. The only inconvenience is sitting for about 4 hours with a plastic needle in your vein. It's somewhat uncomfortable but that's all it takes to become a donor. This procedure is safe and does not harm donor's health in any way. There is no impoverishment of the bone marrow – what is taken is a tiny portion of our total number of stem cells.

Is there a chance of complications from being a donor?

In theory any medical procedure can cause complications, but stem cell transplant is extremely safe – the chance of complications is one in a million. It is true that stimulating agent can cause enlarged spleen. But we are performing thousands and thousands of transplants without any problems.

Why is it so difficult to find a suitable donor?

Usually it's quite easy to find a donor for Ashkenazi Jews. But in this specific case it's proven very difficult, since Eli has a very rare genetic makeup. The match of all the parameters has to be 9 out of 10, otherwise the procedure can kill the patient. For the majority of the patients we are able to find a donor. Tel Ha Shomer hospital alone performs 3-4 transplants a day, 7 days a week including holidays and weekends.

What is the donors registry?

It's the blood samples* taken from the potential donors. This information goes into the Israeli and international registers. Very often we get samples from other countries. If they come from the relatives of the patient, they are sent to the special laboratory to test the tissue match.

Transplants are usually required for bone marrow cancers (chronic leukaemia, acute leukaemia, more rarely for lymphomas). Unfortunately the number of patients diagnosed with these diseases keeps growing. First of all, the rate of cancer in the population increases. Second, we have improved early diagnostics which gives better chances of survival and cure. Third, the modern methods and supporting techniques make the transplant available for a wider range of patients. Today we perform successful transplants for 65 and even 70 years old patients.

How many times can someone become a stem cell donor?

Usually the donor gives stem cells once. Rarely it would be done twice, if the same patient received the cells from this donor in the past. We don't use the same donor more than twice.

* In countries other than Israel joining the registry is made by collecting a swab of cheek cells, not by blood test.

This text was prepared using information from http://newsru.co.il