Did you know that bone marrow can be banked like blood? Did you know that we
can now do bone marrow transplants from people that are unrelated to the donor?
Its possible. With the help of the National Bone marrow Donor Registry in
Minneapolis, we can match patients needing a transplant with potential donors.
This is an incredible advance for those patients who need a transplant.
Patients with certain kinds of leukemia, and certain life-threatening anemias
need transplants to be cured. Before, the problem was that only about 30% of
the patients had a compatible sibling donor. 70% died. With the registry,
another 30-40% can find a match. The registry works great for white people
because there are a lot of them on the registry. Black and Hispanic patients
are not nearly as fortunate. For them, finding a match is quite rare.
If you would like to be a bone marrow donor, especially if you are black or
hispanic, please contact you local blood bank, or the National Registry, or
leave me a message on the echo. By the way, there are similar registries in
Europe, and Canada, so if you would like to register in Europe, please contact
them at you locale.
Jim Harper, MD
Ped. Heme/Onc
Gainesville, Fla
ATH: 3601/14 151/1003 265/7 103/501
–
Uucp: …{gatech,ames,rutgers}!ncar!noao!asuvax!stjhmc!3601!14.0!Jim.Harper
Internet: Jim.Har…@p0.f14.n3601.z1.fidonet.org
What is involved in doning bone marrow. It seems as if they would have to cut
pretty deep and leave a fairly big hole to get bone marrow. Is it done with
needles. Be frank, how much does it hurt? How brave do you have to be?
2/1
–
Uucp: …{gatech,ames,rutgers}!ncar!noao!asuvax!stjhmc!233!4!Jean.Nance
Internet: Jean.Na…@f4.n233.z1.fidonet.org
In article <6655.253B6…@stjhmc.fidonet.org> Jean.Na…@f4.n233.z1.fidonet.org (Jean Nance) writes:
>What is involved in doning bone marrow. It seems as if they would have to cut
>pretty deep and leave a fairly big hole to get bone marrow. Is it done with
>needles. Be frank, how much does it hurt? How brave do you have to be?
From the sci.med archives
Bone Marrow Transplants
Bone marrow transplants are done for hematologic diseases
such as leukemia for the most part. They are done using HLA matched donors.
Not only the A and B loci are matched, as in apheresis, but
the C & D as well. An MLC culture must also be compatible
between donor and recipient. Large computer databases now
allow non-family donors to be matched. The marrow is drawn
from the pelvic bones of the donor by aspiration through a
large bore cannula. The posterior iliac crests and sometimes
the anterior crests are used. The procedure is done under
regional or general anesthesia. There have been no donor deaths
reported. Most complications are local & due to hematoma
formation. The donor usually can go back to work in a day
or two. The recipient (who had almost nil chance of survival
prior to transplants) has about a 30-50% chance of being saved
by the graft. If you sign up for the registry, the chances that
you will ever be asked to donate are very small.
As a practicing hematologist, I did several hundred bone marrows and was
the recipient of a couple (one to see what it felt like, and one as a
favor to a fellow researcher), I know this particular procedure reasonably
well.
The procedure involves numbing the skin over the "ilaic crest", the
top ridge or "wing" of the pelvis, just below the belt line. (Marrows
can also be done on the sternum). The periosteum is also injected with
anesthetic, then a two-piece hollow needle about the size of a nail used
to hold 2×4′s together is inserted into the marrow cavity. Up to this
point, there is generally little if any discomfort (except for a few
seconds of minor burning sensation where/when the anesthetic is injected).
Then suction is applied to suck out marrow for a few seconds. This is
the only really uncomfortable part of the procedure; most folks grimace
a little, a few scream; when I had it done to myself I was surprised how
little it hurt. A marrow biopsy is often done along with the aspiration,
and this is generally only felt as moderate pressure.
During bone marrow donation, however, most centers use general anesthesia,
since the procedure described above is repeated dozens of times in order
to get enough marrow for a useable donation.
Dan Masys, MD
ma…@mcs.nlm.nih.gov
To donate bone marrow, you must go through a three step process.
1>You would have blood drawn to determine your HLA type. This is the antigens
present on white blood cells and tissue, that allow our immune system to
differentiate self from non-self.
2>If you matched the particular recipient, such as a sib, or an unrelated
recipient, more blood would be drawn to do an MLC, or mixed lymphocyte culture.
This test is done in the lab and tells us whether or not the donor and
recipient are truly matches, or whether there will be a reaction between the
marrow and the host (a disease called graft vs host) or between the host and
the marrow (rejection.)
3>Then, if your MLC’s are compatable, the donor would have a pre-op
counselling session to answer questions and so forth, then if he or she is
medically suitable for surgery, the donor would then donate the marrow. The
process (without being too gory) is rather simple.
The donor has either general or spinal anesthesia, then the lower back and
pelvis is prepped with surgical soap, and once the proper level of anesthesia
has been achieved, bone marrow is aspirated from the pelvis bone using a needle
designed for such a purpose. The
bone marrow comes out looking much like blood, and the donor may need a
transfusion afterward, but this can be done using the donors own blood (by
using self-donated blood that has been stored up for such a need.) After the
procedure, the donor may be discharged from the hospital that day, or may be
admitted for fluids and observation overnight.
Some donors need some iron supplements afterwards for a couple of months. Most
people have little or no problem with pain, and need nothing more than mild
analgesics for a day or two.
Give it some thought.
Jim Harper
1003 265/7 103/501
–
Uucp: …{gatech,ames,rutgers}!ncar!noao!asuvax!stjhmc!3601!14.0!Jim.Harper
Internet: Jim.Har…@p0.f14.n3601.z1.fidonet.org
As the sci.med archive on bone marrow donation said, your chances of being
needed to donate are small, but if you or anyone else out there is interested,
especially if you’re black or hispanic, PLEASE
consider it. You as an individual may not be needed, but then there are a lot
of people out there who need marrow, and have NO match. Who knows, maybe you
can do something wonderful for someone else.
3601/14 151/1003 265/7 103/501
–
Uucp: …{gatech,ames,rutgers}!ncar!noao!asuvax!stjhmc!3601!14.0!Jim.Harper
Internet: Jim.Har…@p0.f14.n3601.z1.fidonet.org
By and large most transplanters agree that a 69 year old donor would not be the
best candidate due to the age of the bone marrow and loss of plasticity of the
stem cell lines. Consider yourself oficially off the hook. However, for the
rest of you out there in Echo-land,
give it some thought.
We really have a serious need for bone marrow. Especially for black and
hispanic children. The registry has only 1% black and 1% hispanic donors. The
odds that a donor could be found for a child in either of these two ethnic
groups is vanishingly small. For a child with aplastic anemia, this really
decreases their chance for survival.
Thanks for the interest.
–
Uucp: …{gatech,ames,rutgers}!ncar!noao!asuvax!stjhmc!3601!14.0!Jim.Harper
Internet: Jim.Har…@p0.f14.n3601.z1.fidonet.org
My husband had a bone marrow biopsy done last winter. From what
has been said, it sounds a lot like bone marrow donation, except
they probably don’t take nearly as much. I was dreading this,
having heard it was awful. The doctor who did the proceedure
had a very gentle touch. He used sucessive local anesthetics
so that the pain was dealt with at the surface, then down to
the bone. Michael said it wasn’t any worse than getting a
tooth filled. If you are going to have this done, you could
ask how they handle the anesthetic.
Janet McN
In article <6827.25455…@stjhmc.fidonet.org> Jim.Har…@p0.f14.n3601.z1.fidonet.org (Jim Harper) writes:
>We really have a serious need for bone marrow. Especially for black and
>hispanic children. The registry has only 1% black and 1% hispanic donors. The
>odds that a donor could be found for a child in either of these two ethnic
>groups is vanishingly small. For a child with aplastic anemia, this really
>decreases their chance for survival.
Is there such an inherent difference between bone marrow of blacks, hispanics,
whites, etc. so that people can only get it from members of their
own race?
Salit
sa…@cs.duke.edu