Bone marrow donation: collection procedure, types and possible consequences. How does the bone marrow donation procedure work, are there any consequences for the donor? What does bone marrow donor mean?
In this article you will find answers to your questions.
Bone marrow transplant - questions and answers about all stages of transplantation
In Israel, bone marrow transplants are successfully performed in many clinics. Several of my Israeli patients have successfully undergone bone marrow transplantation.
Contents of the article on bone marrow transplants
- What is bone marrow
- Why is a bone marrow transplant necessary?
- Types of bone marrow transplant
- Preparing for transplant
- Receiving bone marrow from a donor
- Preparatory regimen for transplantation
- Bone marrow transplant procedure.
- Engraftment of bone marrow
- How does the patient feel during transplantation?
- How to cope with emotional stress?
- Discharge from hospital
- Life after bone marrow transplant
- Is it worth it?
- What is a stem cell transplant?
- Bone marrow transplants in Israel.
Bone marrow transplantation
is a relatively new medical procedure that is used to treat diseases that were previously considered incurable.
Since its first successful use in 1968, used to treat patients suffering leukemia (blood cancer), aplastic anemia, lymphomas (such as lymphogranuomatosis or Hodgkin's lymphoma, multiple myeloma, serious immune disorders and certain malignancies such as breast or ovarian cancer).
In 1991, more than 7,500 patients underwent the procedure in the United States bone marrow transplants. Although transplantation today saves thousands of lives every year, 70 percent of patients in need of transplantation— do not pass it due to the impossibility of finding a compatible donor.
WHAT IS BONE MARROW
Bone marrow- This is spongy tissue that is found inside large bones. Bone marrow in the sternum, skull bones, femurs, ribs and spine contains stem cells from which blood cells are produced. These are white blood cells - leukocytes that protect the body from infections, red blood cells - red blood cells that carry oxygen, and platelets that allow blood to clot.
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WHY IS IT NEEDED? ?
In patients with leukemia, aplastic anemia and some immune deficiencies, stem cells bone marrow are not functioning correctly. They either produce an excess of defective or immature blood cells (in the case of leukemia) or dramatically reduce their production (in aplastic anemia).
Defective or immature blood cells fill Bone marrow and blood vessels, displace normal blood cells from the bloodstream and can spread to other tissues and organs.
To destroy diseased blood cells and bone marrow large doses of chemotherapy and/or radiotherapy are required. Such treatment damages not only defective but also healthy cells.
Likewise, aggressive chemotherapy used to treat some lymphomas and other cancers destroys cells bone marrow. Bone marrow transplantation allows doctors to treat such diseases with intensive chemotherapy or radiation, followed by replacement of the diseased or damaged bone marrow healthy.
Although bone marrow transplantation Although it does not provide a 100% guarantee that the disease will not return, this operation may increase the likelihood of recovery - or at least extend the disease-free period and prolong life for many patients.
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KINDS BONE MARROW TRANSPLANTS
At bone marrow transplant, sick bone marrow the patient is destroyed and healthy bone marrow the donor is injected into the patient's bloodstream. Upon successful transplantation, the transplanted Bone marrow migrates into cavities in large bones, takes root and begins to produce normal blood cells.
If used Bone marrow received from a donor, such a transplant is called allogeneic, or syngeneic if the donor is an identical twin.
In case of allogeneic (i.e. not from a relative) transplant, donor Bone marrow, administered to the patient, must genetically match his own as much as possible.
To determine the compatibility of the donor and recipient, special blood tests are performed.
If donor Bone marrow does not genetically match the tissues of the recipient enough, it can perceive the tissues of his body as foreign material, attack and begin to destroy it.
This condition is known as graft-versus-host disease (GVHD) and can be life-threatening. On the other hand, the patient's immune system can destroy the transplanted Bone marrow. This is called graft rejection.
There is a 35% chance that the patient will have a sibling whose Bone marrow will fit perfectly. If the patient does not have suitable transplants relatives, the donor can be found in the international donor registry bone marrow, or - can be used transfer not fully compatible bone marrow.
In some cases, the patient may be a donor bone marrow for myself. This is called an "autologous" transplant and is possible if the disease affecting Bone marrow, is in remission, or when the condition requiring treatment does not affect Bone marrow(for example, when breast cancer, ovarian cancer, lymphogranulomatosis, non-Hodgkin lymphoma and brain tumors).
Bone marrow is extracted from the patient and can be "purified" to remove diseased cells in the case of diseases affecting Bone marrow.
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PREPARATION FOR TRANSPLANT
Successful transfer possible if the patient is “healthy enough” to undergo such a serious procedure, which is bone marrow transplant. Age, general physical condition, diagnosis and stage of illness are all taken into account when deciding whether a patient may undergo transplantation.
Before transplantation The patient is subjected to a battery of tests to ensure that the patient's physical condition will allow him to endure bone marrow transplant.
Tests of the heart, lungs, kidneys and other vital organs are also used to obtain information about their baseline levels so that after comparisons could be made to determine whether any function had improved. Preliminary tests are usually performed on an outpatient basis, before hospitalization.
Successful bone marrow transplantation requires a highly professional medical team - doctors, nurses, support staff who have good experience in this field, and are trained to immediately recognize possible problems and side effects, and know how to respond quickly and correctly to them. In business bone marrow transplants there are a lot of little things, knowledge and consideration of which can have a very significant impact on the results transplants.
Choosing the right center for execution bone marrow transplantation is essential to obtain the desired result.
A good transplant program will include providing patients and their families with emotional and psychological support - before, during and after transplants.
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RECEIVING BONE MARROW FROM A DONOR
Regardless of whether the bone marrow from the donor or the patient himself is used for transplantation, the procedure for obtaining the material is similar in both cases. Bone marrow is collected in the operating room, usually under general anesthesia. This leads to minimal risk and minimizes discomfort.
While the patient is under anesthesia, a special needle is inserted into the cavity of the femur of the leg or the iliac bone of the pelvis, where a large amount of bone marrow is usually located.
Bone marrow is a red, fatty liquid that is drawn through a needle into a syringe. Typically, several skin punctures are required in both femurs and multiple bone punctures to obtain sufficient bone marrow. There is no need for any skin incisions or stitching - only needle punctures are used.
Quantity required for bone marrow transplants depends on patient size and cell concentration bone marrow in the taken substance. Usually take from 950 to 2000 milliliters of a mixture consisting of bone marrow and blood. Although this amount seems large, it actually represents only about 2% of a person's bone marrow volume, and a healthy donor's body replenishes it within four weeks.
When the anesthesia wears off, the donor may feel some discomfort at the puncture site. The pain is usually similar to that experienced after a hard fall on ice and is usually relieved with painkillers.
The donor, who is not expected to undergo a future bone marrow transplant, is discharged from the hospital the next day and can return to normal activities within the next few days.
In autologous transplantation, the harvested bone marrow is frozen and stored at -80 to -196 degrees Celsius until the date of transplantation. It may first be cleaned to remove any remaining cancer cells that cannot be identified under a microscope.
In allogeneic transplantation, bone marrow can be processed to extract T cells to reduce the risk of graft-versus-host disease
(graft-versus-host disease). The bone marrow is then transferred directly to the patient's room for intravenous administration.
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PREPARATION REGIME FOR TRANSPLANTATION
A patient admitted to a bone marrow transplant unit first undergoes several days of chemotherapy and/or radiation, which destroys his own bone marrow and cancer cells to make room for new bone marrow. This is called conditioning or preparatory mode.
The exact regimen of chemotherapy and/or radiation depends on the patient's specific disease and the protocol and preferred treatment plan of the department performing the transplant.
Before the prep regimen, a small flexible tube called a catheter is inserted into a large vein, usually in the neck. This catheter is required by medical personnel to administer medications and blood products to a patient, and to avoid hundreds of punctures in the veins in the arms to take blood tests during treatment.
The dose of chemotherapy and/or radiation that is given to the patient during preparation is significantly higher than the doses that are administered to patients suffering from diseases that do not require a bone marrow transplant. Patients may feel weak, nauseated and irritable. In most bone marrow transplant centers, patients are given anti-nausea medications to minimize discomfort.
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BONE MARROW TRANSPLANT PROCEDURE
One to two days after the administration of chemotherapy and/or radiation, the bone marrow transplant itself is performed. The bone marrow is given intravenously, similar to a blood transfusion.
Transplantation is not a surgical procedure. It is performed in the patient's room rather than in the operating room. During a bone marrow transplant, the patient is often checked for fever, chills, and chest pain.
After the transplant is completed, days and weeks of waiting begin.
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BONE MARROW ENVIRONMENT
The first 2-4 weeks after a bone marrow transplant are the most critical. High doses of chemotherapy and radiation, which were given to the patient at the preparation stage, destroyed the patient's bone marrow, damaged the immune system and the body's defense system.
While the patient waits for the transplanted bone marrow to migrate into the bony cavities of the large bones, take root there and begin to produce normal blood cells, he is very susceptible to any infection and has a marked tendency to bleed. Many antibiotics and blood transfusions are given to the patient to help prevent and control the infection. Platelet transfusions help control bleeding.
Patients after an allogeneic transplant also receive additional medications to prevent and control graft-versus-host disease.
Extraordinary measures are taken to minimize the risk of infection of the patient by viruses and bacteria. Visitors and hospital staff wash their hands with antiseptic soap and, in some cases, wear protective gowns, gloves and masks when entering a patient's room.
Fresh fruits, vegetables, plants and bouquets of flowers are prohibited from being brought into the patient’s room, as they are often sources of fungi and bacteria that pose a danger to the patient.
When leaving the room, the patient should wear a mask, gown and gloves, which act as a barrier against bacteria and viruses, and warn others that he is susceptible to infection. Blood tests should be taken daily to determine how the new bone marrow is engrafting and to assess the status of body functions.
After the transplanted bone marrow has finally taken root and begins to produce normal blood cells, the patient gradually ceases to be dependent on antibiotics, blood transfusions and platelets, which gradually become unnecessary.
At the point when the transplanted bone marrow begins to produce a sufficient number of healthy red blood cells, white blood cells and platelets, the patient is discharged from the hospital, unless he develops any additional complications. After a bone marrow transplant, patients typically spend 4 to 8 weeks in the hospital.
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WHAT DOES THE PATIENT FEEL DURING TRANSPLANTATION?
A bone marrow transplant is a physically, emotionally and mentally difficult procedure for both the patient and his loved ones.
The patient needs and should receive the best possible help to cope with all this.
Thinking: “I can handle this on my own” is not the best way for a patient to endure all the difficulties associated with a bone marrow transplant.
A bone marrow transplant is a grueling experience for the patient. Imagine the signs of a severe flu - nausea, vomiting, fever, diarrhea, extreme weakness. Now imagine what it's like when all these symptoms last not for a few days, but for a few weeks.
Here is a rough description of what bone marrow transplant patients experience during hospitalization.
During this period the patient feels very sick and weak. Walking, sitting in bed for long periods of time, reading books, talking on the phone, visiting friends, and even watching television require more energy from the patient than he has.
Complications that can develop after a bone marrow transplant - such as infections, bleeding, rejection reactions, liver problems - can cause additional discomfort. However, pain is usually well controlled with medication.
In addition, sores may appear in the mouth, making it difficult to eat and painful to swallow.
Sometimes temporary mental disorders occur, which can frighten the patient and his family, but one must realize that these disorders are temporary. Medical staff will help the patient cope with all these problems.
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HOW TO CANDLE EMOTIONAL STRESS
In addition to the physical discomfort associated with a bone marrow transplant, there is also emotional and mental discomfort. Some patients find that the psychological stress of this situation is even more severe for them than the physical discomfort.
Psychological and emotional stress is associated with several factors.
First, the patient undergoing a bone marrow transplant is already traumatized by the fact that he is suffering from a life-threatening disease.
Although the transplant gives him hope for a cure, the prospect of undergoing a long, difficult medical procedure with no guarantee of success is not encouraging.
Second, transplant patients can feel quite lonely and isolated. Special measures taken to protect patients from infection while their immune systems are compromised can make them feel cut off from the rest of the world and almost all normal human contact.
Patients are kept in a separate, isolated room, sometimes with special air-filtering equipment to remove contaminants from the air.
The number of visitors is limited and they are required to wear masks, gloves and protective clothing to limit the spread of bacteria and viruses when visiting a sick person.
When the patient leaves the room, he is required to put on gloves, a gown and a mask, which are barriers against infection.
This feeling of isolation is experienced by the patient at a time when he most needs physical contact and support from family and friends.
Feelings of helplessness are also a common experience among bone marrow transplant patients, causing them to feel angry or resentful.
For many of them, the feeling that their lives are completely dependent on strangers, regardless of how competent they may be in their field, is intolerable.
The fact that most patients are unfamiliar with the terminology used by medical staff to discuss the transplant procedure also adds to the feeling of helplessness. Many also feel uncomfortable being dependent on others for daily hygiene tasks such as washing or using the toilet.
Long weeks of waiting for the transplanted bone marrow to engraft, for blood tests to return to safe levels, and for side effects to finally subside add to the emotional trauma.
The recovery period resembles a roller coaster - one day the patient feels much better, and the next few days he may again feel seriously ill, as he was in the previous days.
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DISCHARGE FROM HOSPITAL
After discharge from the hospital, the patient continues the recovery process at home (or rents housing near the hospital if he lives in another city) for another two to four months. A person recovering from a bone marrow transplant usually cannot return to their regular job for at least six months after the transplant.
Although the patient is feeling well enough to leave the hospital, his recovery is far from complete.
During the first few weeks he still feels too weak to do anything other than sleep, sit, and walk around the house a bit. Frequent visits to the hospital are necessary to monitor his recovery, administer medications to the patient and, if necessary, administer blood transfusions.
It may take up to six months or more from the date of transplantation for the patient to return to normal activity.
During this period, the patient's white blood cells are often still at levels too low to provide sufficient protection against viruses and bacteria encountered in everyday life.
Therefore, contact with the general public should be limited. Cinemas, grocery stores, department stores, etc. are places prohibited from visiting for a patient undergoing the recovery period after a bone marrow transplant. Such people should wear a protective mask when venturing out of their homes.
The patient returns to the hospital or clinic several times a week for tests, blood transfusions, and other necessary medications. Eventually, he becomes strong enough to return to a normal routine and look forward to returning to a productive, healthy life.
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LIFE AFTER BONE MARROW TRANSPLANTATION
It can take up to a year for the new bone marrow to start functioning like its own. Patients should remain in contact with the hospital during this time to ensure any infections or complications that may develop are detected early.
Life after a transplant can be both exciting and stressful. On the one hand, it's an exciting feeling to feel alive again after being so close to death. Most patients find that their quality of life improves after the transplant.
However, the patient always remains worried that the disease may return again. In addition, ordinary innocent words or events can sometimes trigger painful memories of the transplant period, even long after full recovery.
It may take a long time for the patient to overcome these difficulties.
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IS IT WORTH IT?
Yes! For most patients awaiting a bone marrow transplant, the alternative is almost certain death.
Although a transplant can be a painful time, most transplant recipients find the prospect of returning to a full, healthy life after the transplant worth the effort.
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What is a stem cell transplant?
Today, in many cases, instead of a bone marrow transplant, a peripheral stem cell transplant is performed. The donor, who is compatible with the patient, receives a drug for 4 days that stimulates the release of stem cells from the bone marrow into the blood. The medicine is administered using a regular subcutaneous injection. As a rule, it is well tolerated, although in rare cases there are short-term symptoms reminiscent of a mild flu: muscle pain, weakness, slight fever.
After such preparation, blood is taken from the donor from a vein in one arm, passed through a special apparatus that filters only stem cells from the blood, and then returned to the donor through the veins of the other arm. The entire procedure lasts several hours, does not require anesthesia, and apart from some inconvenience, does not cause any harm to the donor.
In extremely rare cases, drug preparation for a stem cell transplant can cause an enlargement of the donor's spleen, but the frequency of such cases is extremely low.
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BONE MARROW TRANSPLANTS IN ISRAEL.
Israeli hospitals have accumulated extensive experience in bone marrow transplantation.
Despite the fact that the population of Israel is one and a half times smaller than the number of residents of Moscow, there are five bone marrow transplant centers in the country.
Each of them employs qualified teams of doctors specializing in bone marrow transplants in adults and children. The percentage of successful transplants and the number of complications in all these centers correspond to similar indicators of the world's best departments for bone marrow transplantation.
In addition to Israeli residents, these centers accept many patients from abroad for treatment, including from neighboring Arab countries with which Israel does not have diplomatic relations. Arab sheikhs prefer to go to Israel for treatment, although they can choose any hospital for treatment, and not only in the Middle East.
Naturally, many residents of Russia and the CIS countries also receive medical care in these departments.
It is known that the cost of transplants in Israel is lower than in Europe, and much lower than in the USA.
The price of a transplant depends on its type - the cheapest is autologous, when the patient becomes a bone marrow donor for himself.
The most expensive type is a transplant from a poorly compatible donor, as well as a transplant that requires preliminary purification of the bone marrow from cancer cells.
Bone marrow transplants in children cost one and a half to two times higher than in adults, since they require more complex and expensive procedures and treatments.
Price bone marrow transplants
A network of points for bone marrow donors has appeared in the Kama region. In Perm and large cities of the region, anyone can donate a blood sample and be included in the National Register of Potential Bone Marrow Donors. There are very few such donors in our country - due to lack of information and simple human fear. “Zvezda” knows everything about how to become a donor and whether you should be afraid of it.
Why are bone marrow donors needed?
If there is such a “cure”, why is it not possible to save all the sick?
Almost every person has “genetic twins”. Despite this, doctors sometimes cannot find a compatible donor. The fact is that it simply is not on the National Register. This is an information database of bone marrow donors, created jointly by Rusfond and the St. Petersburg State Medical University named after Academician I. P. Pavlov. This database stores data on the HLA phenotypes of all Russians who decide to become bone marrow donors. As soon as a person appears who needs a transplant, a compatible donor with the same HLA phenotype as the patient is searched in the database. The patient and the donor must be genetically compatible in order for the bone marrow to take root in the foreign body after transplantation.
Is it painful to be a bone marrow donor?
There are two ways to donate bone marrow cells. And the donor himself has the right to choose which method to use.
Method one. The donor is hospitalized in the clinic for one day. The bone marrow collection procedure is performed under general anesthesia. Bone marrow is usually taken from the pelvic bones with special needles. Over the course of one and a half to two hours, about a liter of liquid bone marrow is removed through two small incisions in the skin. This represents no more than 5% of the donor's total bone marrow volume. This amount is enough to ensure the patient’s hematopoiesis for the rest of his life. The donor does not feel the loss of bone marrow; its volume is fully compensated within two weeks. The level of hemoglobin in the blood may decrease slightly, but it is also completely restored in one and a half to two weeks. Also, in the first few days after bone marrow collection, the donor may experience pain in the pelvic bones, but a painkiller tablet will relieve this pain.
Method two. The donor is injected subcutaneously with a special drug over the course of five days, which stimulates the release of bone marrow cells into the blood. On the fifth day, the donor is connected to a machine through which his blood is pumped. During this process, which lasts three to five hours, the desired cells are removed and the blood is returned to the donor. During the period of preparation for this procedure, the donor usually experiences aches and pain in the joints. A slight loss of platelets in the blood is also possible, but then everything will be restored over time.
Do you pay for this donation?
Bone marrow donation occurs anonymously, voluntarily and free of charge. But in your piggy bank there will be one saved life!
How to become a bone marrow donor?
First, you need to donate 9 ml of blood for a genetic test. A test tube with your blood will be sent to the Research Institute of Pediatric Oncology and Transplantology named after. R. M. Gorbacheva, who is located in St. Petersburg. This institute has special equipment that allows you to decipher your HLA phenotype. The data obtained will then be registered in the National Bone Marrow Donor Registry.
Are there any contraindications to donation?
Anyone between the ages of 18 and 55 can become a potential donor, but there are contraindications. Pregnant women, HIV carriers, people who have had hepatitis B or C, tuberculosis, malaria, mental disorders, malignant and autoimmune diseases cannot be donors. It is not recommended to undergo the procedure of taking bone marrow for those for whom anesthesia is relatively contraindicated, that is, people suffering from chronic diseases of the respiratory tract and cardiovascular system.
Can a potential donor refuse to donate?
The procedure for potential bone marrow donors entering the register does not obligate anyone to anything. It’s just your desire to become a donor and save someone’s life. The likelihood that your bone marrow will be suitable for a particular patient is very low. But it can still happen. And then, when the National Register contacts you, you can refuse. If consent is given, a repeat compatibility test is carried out with the patient awaiting a bone marrow transplant. And even after that you can still refuse. But then it will be impossible to turn everything back, because before the transplant the patient will undergo intensive chemotherapy, which will completely destroy his hematopoietic and immune system. Refusal will be tantamount to murder. But in fact, potential donors at this stage extremely rarely refuse donation, realizing that someone else’s life depends on their action.
How to prepare for donation?
You need to prepare in the same way as for a regular blood donation. Moreover, donors, as a rule, donate not only 20 ml of blood for genetic analysis, but also 450 ml to the blood bank, which will subsequently be used for blood transfusions to seriously ill patients.
Before going for the test, you need to stop drinking alcohol for two days. On the day of delivery, you must have breakfast. It is better to choose the following menu: porridge with water, hot tea with sugar, crackers/bagels/crackers. Pasta with water and without oil, vegetables (except tomatoes), fruits (except bananas) are also allowed. Fatty, fried, smoked, spicy, as well as eggs, dairy and fermented milk products are strictly prohibited. And don’t forget to take your passport with you, as registration in the Perm Territory is required for at least 6 months.
Where can you become a bone marrow donor?
Artem Kostyukovsky,
special correspondent of Rusfond
Love is a man from National Bone Marrow Donor Registry, which is currently being created by the Research Institute of Pediatric Oncology, Hematology and Transplantology named after. R.M. Gorbachev and Rusfond. We cannot give the last name of our interlocutor - bone marrow donation is anonymous throughout the world. She works as an assistant to the general director of one of the St. Petersburg companies. A year ago, Lyubov was the first in our registry to become a real donor. And she was the first real Russian bone marrow donor to agree to an interview.
The national register of bone marrow donors has been created since August 2013 by employees of the Research Institute named after. R.M. Gorbacheva (St. Petersburg) with donations from readers "Kommersant" And . Rusfond donated over 58 million rubles for the creation of the register. There are currently 2,625 potential donors in the St. Petersburg register. Six have already become real donors - sharing their hematopoietic stem cells with leukemia patients. In the unified database of bone marrow donors, which is created by the Research Institute named after. Gorbachev, there are 29,053 donors.
This database includes Kazakhstan and six regional Russian registers.
– Love, please tell us about yourself.
– I am 30 years old, I am a citizen of Ukraine. I have been living in St. Petersburg since 2005, and have been applying for Russian citizenship for a long time. I hope to receive it in January. My first education was in medicine, I worked as a nurse.
– How did you get into the register?
– I am a blood donor. Three years ago I was told that blood can also be donated for typing - for the bone marrow donor registry. I went and passed it. And I forgot. Two years later they called me: “Remember, you became a potential bone marrow donor?” I didn’t even understand at first what it was about, but then I remembered, of course. I say: “Okay, I agree.”
– Have you consulted with your family?
- I only told my sister. Parents and grandparents – after two months. They would be worried.
– How long did the preparation last?
- A little over a month. Examination, additional tests, then subcutaneous injections of a drug that stimulates the growth of hematopoietic stem cells. They warned that there may be unpleasant sensations, like a cold: fever, pain in the bones. But I didn’t feel anything at all, there were no negative consequences.
– Was it scary at some stage?
“I was told that there are two options for collecting cells: from peripheral blood and through a puncture in the bone under general anesthesia. The choice was mine. I knew that for some patients it would be better to take cells from bone. And I was afraid, not of the puncture, but of general anesthesia. I would have agreed anyway, but the doctors said it was possible from blood.
– How was the procedure?
– Just like regular blood donation, only from both hands. The whole thing lasted four hours. I’ve already talked to all the nurses and doctors, watched a movie, listened to music. One procedure was not enough: I was told that the recipient weighed much more than me, so I had to come for another four hours.
– How did you feel afterwards?
– It’s good on the first day. I arrived by car and wanted to go back myself, but the doctor dissuaded me. He said that he would take me himself. And the second time after the procedure, when I stood up, I felt very dizzy. For the first time I learned what “legs give way” means. I sat with the doctors for an hour, they gave me tea and fed me. Then the doctor took me home.
– How long did it take you to come to your senses?
- No, after two hours it was all over.
– What emotions did you experience during this whole story?
- Amazing. Still, this is a unique event, because coincidences rarely happen. When my brothers and sisters found out, they said: we also want to, we will also become donors. I tell my friends and colleagues that it’s not scary or painful at all.
– Do you know anything about the patient who received your stem cells?
“I only know that this is an adult man, that the transplantation was successful, the cells took root. In general, I wanted to help children. And then I thought: what difference does it make? For some, he is also a child, and for others, perhaps, a dad.
– Would you agree to become a donor again?
– Yes, but you can only become a bone marrow donor for one patient; this is a worldwide practice. So I already took my chance. And I’m very glad that I was able to help.
Red bone marrow in the body of any of us is involved in the process of blood renewal. If for some reason its work was disrupted, this will lead to complex and serious diseases, the number of which is steadily growing. Thus, a person has an urgent need for a bone marrow transplant, which in turn creates a huge demand for donors. This process is quite difficult as it is necessary to find the right person. It is worth noting that a healthy person can make money from this. It is worth knowing only that And in this publication we will talk about this topic in more detail.
Types of bone marrow transplant
Previously, this procedure was not practiced, but currently bone marrow transplantation is used to improve survival in cases of leukemia, treatment, aplastic anemia, lymphoma, myeloma, ovarian, and breast cancer. The main task of any donor is to donate his hematopoietic stem cells, which later become precursors in the event of the emergence of all other blood components. For transplantation of the latter, there are two main types of procedures - autologous and allogeneic transplantation.
Allogeneic transplantation.
This type involves taking bone marrow from a donor who will best suit the genetic patient. Basically, this person becomes a close relative of the patient. This method of transplantation from a donor comes in two types:
Syngeneni. This procedure is performed on an identical twin. Autologous bone marrow transplantation from this donor is absolutely compatible, which in turn completely eliminates the occurrence of an immune conflict.
In the second option, the donor is a healthy relative. And the effectiveness of this procedure will depend entirely on the compatibility of bone marrow tissue in percentage terms. The most ideal is 100% match. But if the compatibility turns out to be very low, then the transplant may be rejected by the body, which will be perceived by the latter as a tumor cell. In addition, there is haploidentical transplantation. In this case the match will be 50%. This procedure is carried out from a person who has no family connection. These conditions are not the most successful, since they have a fairly high risk of various complications.
Autologous.
This procedure consists of freezing previously collected healthy human stem cells and then injecting them into the patient after chemotherapy. If the procedure is carried out successfully, the person’s immune system will begin to quickly recover and the process of hematopoiesis will return to normal. This type of transplantation contains indications in case of remission of the disease, or if the disease has not affected the human bone marrow:
1. For breast or ovarian cancer.
2. For a brain tumor.
3. For non-Hodgkin's lymphoma.
4. With lymphogranulomata.
How to become a donor
Well, the time has come to find out how to become a bone marrow donor for money in Moscow. These tips can also be useful to other city residents. To be included in the bone marrow donor register, a person must be at least 18 and no more than 50 years old. Other requirements for the donor: absence of malaria, hepatitis B and C, tuberculosis, cancer, HIV, diabetes.
In order for a person to be included in the database, he needs to donate nine milliliters of his blood for typing and provide personal information about himself, as well as draw up an agreement to be included in the register. In the event that a person’s HLA type is completely compatible with any patient, he will need to undergo additional studies. First he will need to give his consent. This is required by law. Many people are interested in what it costs to pay donors. In most countries, this type of activity is free, anonymous and gratuitous. Based on this, you cannot sell your own stem cells. They can only be donated.
Who can be a donor
A potential donor is selected according to one of 4 options. They are all different from each other, but pursue a common goal - the maximum degree of compatibility.
The following are suitable for bone marrow transplantation:
- I am sick myself. His disease should be in remission or not affect the bone marrow. The stem cells are processed and frozen.
- Identical twin. Basically, relatives belonging to this type have 100% compatibility.
- Family member. The patient's relatives have a high degree of compatibility. The patient's sister and brothers can also become donors.
A person who is not a relative of the patient. There is a bone marrow donor bank in Russia. - Among the large number of donors registered in this bank, there may be those who are completely compatible with the patient. These registers are also available in the USA, Germany, Israel, etc.
How is bone marrow harvested?
Bone marrow is collected in the operating room. The patient is under general anesthesia at this moment in order to minimize the likelihood of reducing the patient’s discomfort and injury. A special needle with a stopper is inserted into the iliac or femoral pelvic bone, where the largest amount of the required material is contained. Basically, in order to obtain the required amount of fluid, repeated punctures are made. There is no need to cut or sew the fabric. The entire procedure is performed using a syringe and needle. The required amount of donor bone marrow will depend on the concentration of stem cells in the resulting substance and the size of the patient. Basically, a set of 950-2000 ml of bone marrow and blood is produced. You may get the impression that this is a very large volume, but it is worth noting that it is only 2% of the total amount of substance in the human body. Full recovery of such a loss can occur after four weeks.
Currently, donors are offered an apheresis procedure. First, the person is given the necessary drugs to stimulate the release of bone marrow into the blood. Then a procedure similar to donating plasma is performed. Blood is drawn from one arm of the donor, and using special equipment, the stem cells are isolated from the other components. The liquid purified in this way, from the bone marrow, returns to the donor’s body through a vein on his other arm.
How is the transplant performed?
Before undergoing a bone marrow transfer procedure, the patient must undergo an intensive course of chemotherapy, i.e. radical radiation, which is necessary to be able to destroy the diseased bone marrow. Next, the procedure for transplanting pluripotent SCs is performed using an intravenous drip. The process will take about one hour. Donor cells, entering the patient’s bloodstream, begin to take root. In order to speed up the procedure, doctors use means that can stimulate the functioning of the hematopoietic organ.
Consequences for the donor
Any person who wants to become a bone marrow donor definitely wants to know about the consequences of the operation. Medical professionals claim that the risks of this procedure are minimized. They are mainly associated with the characteristics of the human body’s reaction to anesthesia, or to the insertion of a surgical needle. Sometimes, infection occurred at the puncture sites. After this procedure, the donor may experience the following side effects for some time:
1. bone pain.
2. discomfort at the puncture site.
3. muscle pain.
4. nausea.
5. headache.
6. increased fatigue.
Contraindications
Before becoming a bone marrow donor and undergoing the necessary medical examination, you must first carefully study the list of contraindications. They, as a rule, may overlap with points related to the prohibition of blood donation, for example:
1. tuberculosis.
2. donor's age is more than 55 or less than 18 years.
3. hepatitis C and B.
4. mental disorders.
5. malaria.
6. autoimmune diseases;
7. cancer.
8. presence of HIV.
In the human body, red bone marrow performs the function of renewing blood. Disturbances in its functioning lead to serious diseases, the number of which is constantly growing. Thus, the need for a transplant of this element of the body system arises, which creates a demand for donors. The difficulty of the situation becomes finding the right person.
This procedure has not previously been performed, but bone marrow is now being transplanted to treat or improve survival for leukemia (blood cancer), lymphoma, aplastic anemia, multiple myeloma, breast cancer, and ovarian cancer. The main task of the donor is to donate hematopoietic stem cells, which become precursors in the formation of all other components of the blood. There are two main types of procedures for their transplantation - allogeneic and autologous transplantation.
Allogeneic transplantation
This type involves taking bone marrow from a person who best matches the patient’s genetics. As a rule, this becomes a relative. This donor transplant option can be of two types:
Autologous
This procedure involves freezing previously collected healthy stem cells and injecting them into the patient after high-intensity chemotherapy. If the procedure is successful, the person quickly restores the body’s immune system, and the process of hematopoiesis is normalized. This type of transplantation is indicated in case of remission of the disease or when the disease does not affect the bone marrow:
- with a brain tumor;
- ovarian and breast cancer;
- lymphogranulomatosis;
- non-Hodgkin's lymphoma.
How to become a donor
In order to be included in the bone marrow donor registry, a person must be 18-50 years old. Other requirements: no hepatitis C and B, malaria, tuberculosis, HIV, cancer, diabetes. To be included in the database, you must donate 9 ml of blood for typing, provide your data and sign an agreement to be included in the register. If your HLA type is compatible with any of the patients, additional testing will be required. You will initially have to give your consent, which will be required by law.
Some people are interested in how much donors are paid. In all countries, such activities are “anonymous, free and gratuitous”, so stem cells cannot be sold, they can only be donated. Sometimes you can find information calling for finding a donor to help a child with the promise of a reward. In this case, it is possible to sell the material on an individual basis; government agencies do not approve or support such transactions.
Who can be a donor
A potential donor is selected according to one of 4 options. They differ from each other, but pursue one goal - the maximum degree of compatibility. Suitable for transplantation:
How is bone marrow collected?
Bone marrow collection is performed in the operating room under general anesthesia to minimize the likelihood of injury and reduce discomfort. A special needle with limiters is inserted into the femur or iliac pelvic bone, where the maximum amount of material required. As a rule, repeated punctures are performed to obtain the required amount of fluid. There is no need to cut the fabric or sew it up. All manipulations are carried out using a needle and syringe.
The required amount of donor bone marrow depends on the size of the patient and the concentration of stem cells in the taken substance. Typically, 950-2000 ml of a mixture of blood and bone marrow is collected. This appears to be a large volume, but it represents only 2% of the total amount of the substance in the human body. Full recovery of this loss will occur in 4 weeks.
Now they also offer donors to use the apheresis procedure. To begin with, a person is given special drugs that stimulate the release of bone marrow into the blood. Next, a procedure similar to donating plasma occurs. Blood is taken from one arm, and special equipment isolates the stem cells from the other components. The cleared fluid from the bone marrow is returned to the person's body through a vein in the other arm.
How does the transplant take place?
Before the transfer procedure, the patient undergoes an intensive course of chemotherapy, radical radiation necessary to destroy the diseased bone marrow. After this, pluripotent SCs are transplanted using an intravenous drip. The procedure usually takes one hour. Once in the bloodstream, donor cells begin to take root. To speed up the process, doctors use drugs that stimulate the functioning of the hematopoietic organ.
Consequences for the donor
Every person, before becoming a bone marrow donor, wants to know about the consequences of the operation. Doctors note that the risks during the procedure are minimal and are often associated with the individual characteristics of the body’s reaction to anesthesia or the insertion of a surgical needle. In rare cases, infection has been reported at the puncture site. After the procedure, the donor may experience side effects:
- painful sensation at the puncture site;
- bone pain;
- nausea;
- muscle pain;
- increased fatigue;
- headache.
Contraindications
Before becoming a voluntary bone marrow donor and undergoing examination, you should familiarize yourself with the list of contraindications. They largely overlap with the clauses prohibiting blood donation, for example:
- age more than 55 or less than 18 years;
- tuberculosis;
- mental disorders;
- hepatitis B, C;
- autoimmune diseases;
- malaria;
- presence of HIV;
- oncological diseases.
Video about bone marrow donation
Reviews
Elena, 33 years old
I really wanted to become a donor, but I am terribly afraid of bone punctures and pain. It turned out that you can donate the material along with blood. To do this, you need to take the medicine for a while, and the stem cells enter the bloodstream. Next, blood is taken along with it. The procedure takes longer, but there is no need to pierce the bones or general anesthesia.
Alena, 27 years old
Before becoming a bone marrow donor, I was very worried that it would be very painful. I often saw in TV shows how this procedure goes, how much it hurts people. Then it turned out that it was a bone marrow puncture, and its collection is less painful. When taking medications before the test, I felt tired, but after the procedure everything went away.
Kirill, 30 years old
When I was looking for how to become a voluntary bone marrow donor, I did not find information about whether it was possible to refuse once already in the database. As it turned out, it is possible. If for some reason you cannot undergo the procedure, you can refuse. I’ve been on the donor registry for 2 years now, and they haven’t called me yet.
The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.
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