Common Misconceptions

I am on my 3rd day in the hospital. My doctor noticed that my skin is a little red today so he has me on IV Benadryl (25mg) every 6 hrs. I get very drowsy from it (both in pill and IV form) . For other sensitive people, it is good to ask your nurse to inject the drug slowly so your body can adjust to it. Sometimes if the nurse pushes the drug in quickly it hits me hard and I get choked up/paranoid because the drug makes me feel totally different. One minute you are alert, the next minute you feel like a zombie. It also helps to have a conversation while you get the injection to keep you distracted.

Today I wanted to talk about common misconceptions regarding the Bone Marrow Donor process. People have been asking a lot of great questions and I would like to try and clarify.

Quick Clarification
1. To register to become a donor, all you need to do is give a cotton swab sample of the inside of your cheek. They do NOT draw any blood to enter you into the National Marrow database. Basically, you use a Q-tip to rub the inside of your cheek the same way you would use the Q-tip to clean your ears. Your cheek cells will get onto the Q-tip. The doctor is looking for your cheek cells NOT your saliva.

2. Your Q-tip sample will then get tested for your tissue types. **One very common misconception is that your blood type must match the patient's. This is not true.** To perform a bone marrow transplant the patient's tissue type must match the donor's tissue type. Each person has many different tissue markers. Ideally, doctors prefer 6 different tissue markers between a donor and a patient to match before a bone marrow transplant (BMT) is performed.

Nowadays, doctors go even further by trying to match 10 tissue marker types. This reduces the chance of the patient's body rejecting the donor's stem cells. Your blood type is completely irrelevant.

3. When you get entered into the database you will be available for anyone who is looking for a donor. If you match someone, you will go in for more testing to make sure you are a good match. If the doctor selects you, you will get to decide if you still want to go through the process. Please note that you may be the only match that patient has. If you decline, the person will most likely die. It is important to stay committed as a donor.

4. You can donate more than once. So if you match both me and another patient, you can donate to both. I will not lose my opportunity for your donation.

5. There are two different ways to extract stem cells from a donor. Stem cells are what makes your blood cells. They live in your bone marrow. In Leukemia patients, our stem cells make cancer cells and do not produce healthy blood cells. As a result, we need a transplant from someone who has stem cells that will produce healthy blood cells.

5a. The first procedure is called the marrow donation process. First the donor will receive some pain medication. Next the donor will go into surgery to remove a core piece of marrow which will then be transplanted into the patient. The donor can expect to have pain that is comparable to "falling on your tail bone on ice." The pain/ache can last 1-2 days to sometimes a week depending on the person, but the procedure is normally performed outpatient. Back in the days, this was the only way to give the patient stem cells. However, today this is only performed less than 30% of the time.

5b. Currently, over 70% of the time, the doctor performs a process called Peripheral Blood Stem Cell (PBSC) Donation. This is where the doctor collects stem cells in your blood. First, you will be given daily shots of medicine for 5 days to make your body produce extra stem cells. This will cause the extra stem cells to leave your bone marrow and enter your blood stream. Then the doctor will collect your blood to extract the stem cells. They will have a machine that separate the stem cells from the blood. Once the stem cells have been collected, the rest of your blood will be transfused back into you. The procedure is similar to when you donate blood. This is a much less invasive than the marrow donation process.

6. One last type of transplant is called a cord blood transplant. This is the latest technology for stem cell transplants. When a woman has a baby, the doctor must throw away the umbilical cord and placenta after delivery. However, there are healthy stem cells in the umbilical cord and placenta. Women can agree to donate this waste and it will be entered into the National Marrow database. If there is a match, the doctor can extract the stem cells from these parts to transfuse into the Leukemia patients body. This does not harm the mother or the baby in any way.

7. There is no long term side effects for the donor. You will not get AIDS, hepatitis, etc. because the instrument used is sterile and bone marrow is being removed from you, not being given to you by someone else so there is no transmission of any weird diseases.

8. There is no cost to the donor. Everything is paid for by the patient and his/her medical insurance.

For more information please visit the NMDP website.