About the Donation Process
There are two ways a volunteer donor can donate healthy blood forming cells: through marrow aspiration, or peripheral blood stem cell (PBSC) donation.
Donation occurs at either a collection center (our inpatient affiliate, Brigham and Women’s Hospital) for marrow donations, or at an apheresis center (Dana-Farber Cancer Institute’s Kraft Family Blood Donor Center) for PBSC donations. Both donation processes are designed and monitored to protect the donor’s health and safety.
Before you are requested to donate to a patient, there is an intermediary step, Confirmatory Typing, where we take blood samples to make sure you are the best match and are healthy to donate your cells. If you are chosen as the best match, we will perform a complete physical workup to confirm that you are healthy enough to proceed with donation.
If you are requested as a potential match for a patient, there will be no cost to you. All medical expenses are covered by the NMDP and the patient’s insurance.
Bone Marrow is a spongy tissue inside of bones where the body’s blood cells (red cells, white cells and platelets) are made. Marrow donation is a surgical procedure that takes place in an operating room. You will be given either general or regional anesthesia so you do not feel any pain during donation.
While under anesthesia, doctors use special sterile hollow needles to withdraw liquid marrow from the back of your pelvic bones. Many donors receive a transfusion of their own previously donated blood after the procedure.
We collect only a fraction of the body’s total marrow, and donation lasts approximately 90 minutes. The amount of marrow donated does not weaken your immune system. Your marrow fully replaces itself within a few weeks.
After donation, you will remain in recovery and under observation until the anesthesia wears off. Most donors go home that same day.
You can expect to feel some soreness in your lower back for a few days or longer. With adequate rest, most donors are back to work in a few days. You should be back to your normal physical routine in a few weeks.
Peripheral Blood Stem Cell (PBSC) donation
Blood Stem Cells are cells found in the body that can grow into a red blood cell, a white blood cell, or a platelet. Some blood stem cells are found in the peripheral blood, which flows through the bloodstream in the body.
There are not enough stem cells in the peripheral blood for transplant into a patient; so additional cells are moved out of the marrow and into the bloodstream by using a drug called filgrastim. You receive daily injections of filgrastim for four days before your collection and a fifth injection on the day of your collection.
The additional cells mobilized by the filgrastim injections are then collected by a procedure called apheresis.
During apheresis, blood is drawn from one arm through a sterile needle and circulated through a machine that removes the mobilized blood forming cells, platelets, and some white blood cells. Plasma and red blood cells are returned to your body through the other arm, while the blood forming cells are put into a collection bag. All the tubing used in the machine is sterile and used only once for your donation.
Apheresis collections can be one or two days, depending on the volume of cells requested by the patient’s transplant physician. If only one day of apheresis donation is needed, the process may take up to eight hours. If two donations are requested, the donor returns to Dana-Farber for a second day, with each collection day ranging from four to six hours.
Common side effects of filgrastim are headaches, or bone or muscle aches for several days before collection. Past donors have reported that these side effects subside after the first day of donation.
Your donor center is your advocate before, during and after your donation. We care very much about your safety. After donation, we will call you on a regular basis, and your heath assessed until you report a complete recovery.
Donor insurance coverage
The NMDP provides health insurance for every donor. The insurance program includes medical treatment for any complications related to the donation procedure.
Cord blood donation
In addition to marrow and PBSC, a third source of healthy cells is available through cord blood.
Cord blood is the blood of newborns found in the umbilical cord and placenta. It contains large numbers of blood stem cells. For this reason, blood stem cells from the placenta and umbilical cord are collected after birth and stored for transplant. These cells are different from embryonic stem cells, which come from human embryos. Stem cells from embryos are not used for marrow or blood stem cell transplants.