Most donors are back to their usual routine in a few days, and your marrow naturally replaces itself within four to six weeks. The donation will be scheduled at a hospital that works with the NMDP.
Peripheral blood stem cell PBSC donation is a way to collect blood-forming cells for transplantation. The same blood-forming cells sometimes called blood stem cells that can be donated from the bone marrow are also found in the circulating peripheral blood.
Before donation, a donor takes injections of a drug called filgrastim to move more blood-forming cells out of the marrow and into the bloodstream. Then the donor's blood is removed through a needle in one arm and passed through a machine that separates out the blood-forming cells. This process is similar to donating plasma. The study is investigating whether blood-forming cells from the peripheral blood can be used as effectively as blood-forming cells from bone marrow for unrelated donor transplantation.
A clinical research study has a written set of instructions for how a donation will be carried out. It is an important scientific way to evaluate the effectiveness of the procedure for both donors and recipients.
Receiving filgrastim injections: To move more blood-forming cells from your bone marrow to your bloodstream, you will receive filgrastim, a drug given by injection each day for five days before the donation. The first injection will be given at a donor center or medical clinic. You may receive injections on days two, three and four at your place of work, your home, at a donor center or at a medical clinic. On the fifth day, you will receive your final dose of filgrastim, and then donate your blood cells at the donor center or hospital outpatient unit.
Donating the cells: PBSC donation is done through a process called apheresis, which is similar to donating plasma. During apheresis, a needle will be placed into each of your arms. Blood will be removed from a vein in one arm and passed through tubing into a blood cell separator machine. The machine collects blood-forming cells, platelets and some white blood cells. Plasma and red blood cells are returned to your body through the other arm.
All the tubing used in the machine is sterile and is used only once for your donation. If only one donation is done, it may take up to eight hours.
If two donations are done on separate days, each collection will take four to six hours. Donors may experience headaches or bone and muscle pain, similar to a cold or the flu, for several days before collection. These are side effects of the filgrastim injections that disappear shortly after donation.
Other common side effects are nausea, trouble sleeping and tiredness. Less than one percent 0. The PBSC donation procedure can also have side effects. Some donors experience tingling around the mouth, fingers and toes and mild muscle cramps.
This is caused by the anti-coagulant blood thinner used in the apheresis procedure. These symptoms are easily treated with calcium replacement or by slowing down the procedure. Other common side effects include bruising at the needle site, chills and a decrease in the blood platelet count.
PBSC donation may require placement of a central line if you do not have suitable arm veins. A central venous line is a sterile tube that is inserted into one of the larger veins — the femoral vein, internal jugular vein or subclavian vein.
The risk of serious complications from use of a central line is small. A central line will be placed only with your consent after you have received information about the possible risks. Another potential risk is associated with filgrastim injections. Though filgrastim is commonly used to treat cancer patients, the use of filgrastim in healthy donors is fairly new. Therefore, no data are yet available about the long-term safety.
We began using filgrastim to aid in transplants in the s. Since then, no donors from the registry have reported any long-term complications from filgrastim injections. Before the donation, you will receive five days of filgrastim injections. The first must be given at a donor center or medical clinic, and the fifth will be given at the location where you will undergo the donation procedure. The injections on days two through four may be given at your place of work, your home, at the donor center or a medical clinic.
If your recipient's transplant center is in the U. However, each country has different rules about giving updates. If your recipient is at a transplant center in another country, you may never receive an update or updates on your recipient. During the first year after transplant, some centers allow anonymous communication between you and your recipient.
They can help you weigh the risks and complications against the potential benefits of this procedure. There are two major types of bone marrow transplants. The type used will depend on the reason you need a transplant. They typically involve harvesting your cells before beginning a damaging therapy to cells like chemotherapy or radiation.
After the treatment is done, your own cells are returned to your body. It can only be used if you have a healthy bone marrow.
However, it reduces the risk of some serious complications, including GVHD. Allogeneic transplants involve the use of cells from a donor. The donor must be a close genetic match. Often, a compatible relative is the best choice, but genetic matches can also be found from a donor registry. Allogeneic transplants are necessary if you have a condition that has damaged your bone marrow cells.
However, they have a higher risk of certain complications, such as GVHD. This can leave you susceptible to illness. The success of an allogeneic transplant depends on how closely the donor cells match your own. You may also undergo radiation or chemotherapy to kill off all cancer cells or marrow cells before you get the new stem cells. Bone marrow transplants take up to a week. Therefore, you must make arrangements before your first transplant session. These can include:.
During treatments, your immune system will be compromised, affecting its ability to fight infections. This reduces your risk of being exposed to anything that could cause an infection. You can write down the answers or bring a friend to listen and take notes. Some hospitals have counselors available to talk with patients. The transplant process can be emotionally taxing. Talking to a professional can help you through this process. The procedure is similar to a blood transfusion. During a bone marrow harvest, cells are collected from both hipbones through a needle.
Their stem cells are more likely to help patients than stem cells from older people. The cells or blood is then tested for special proteins, called human leukocytes antigens HLA. HLAs help your infection-fighting system immune system tell the difference between body tissue and substances that are not from your own body.
Bone marrow transplants work best if the HLAs from the donor and the patient are a close match. If a donor's HLAs match well with a person who needs a transplant, the donor must give a new blood sample to confirm the match. Then, a counselor meets with the donor to discuss the bone marrow donation process. Peripheral blood stem cell collection.
Most donor stem cells are collected through a process called leukapheresis. Bone marrow harvest. This minor surgery is done under general anesthesia. This means the donor will be asleep and pain-free during the procedure. The bone marrow is removed from the back of your pelvic bones. The process takes about an hour. After a bone marrow harvest, the donor stays in the hospital until they're fully awake and can eat and drink.
Side effects include:. There are very few risks for the donor and no lasting health effects. Your body will replace the donated bone marrow in about 4 to 6 weeks. Stem cell transplant - donation; Allogeneic donation; Leukemia - bone marrow donation; Lymphoma - bone marrow donation; Myeloma - bone marrow donation. American Cancer Society website. Stem cell transplant for cancer.
Accessed November 3, Fuchs E.
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