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Resource Guide for Bone Marrow/Stem Cell Transplant

The Donor

Unless you are having an autologous transplant, a bone marrow/stem cell donor must be identified to give you your new stem cells. Often it is a brother, sister or another family member. A sibling offers as much as a 30 percent chance of being a good match. Having an identical twin sets you up for a perfectly matched syngeneic transplant.

When there's no related donor match for you, a search begins to locate a "matched unrelated donor" (MUD). The likelihood of finding a matched unrelated donor increases as the number of volunteers on various marrow registries grows. Two factors are important in locating a match. The first is a test known as HLA (human leukocyte antigen) typing. The antigen is a substance, acting like a marker, unique to you, not unlike a set of fingerprints. Part of your genetic make-up is being matched to that of a donor. A simple blood test is all it takes to begin the process of HLA typing. Most HLA typing today is performed using a DNA based method, which provides highly specific information, used to match patients and donors. DNA testing allows patients and donors to be more closely matched. The goal is to find a match for six key antigens.

You do not have to have the same blood type as your donor to be a suitable match. If blood types are different, you will become the donor's blood type after the transplant. This is because the stem cells from a donor have been "programmed" to produce the donor's blood type and will continue to do that in their new environment.

One potential problem in finding a matched unrelated donor may be the lack of representation of your ethnic or racial group in the registries. Because these antigen/tissue types are inherited, and some are unique to racial or ethnic backgrounds, the greatest chance of locating a donor may come from the same group. Ambitious efforts to increase the number of minority donors on the bone marrow registries are underway.

Knowing who should and should not be tested as a donor is often a topic of concern. Friends, coworkers and others interested in becoming a bone marrow donor may either contact a local Red Cross chapter or one of the large registries like the National Marrow Donor Program.These organizations will be aware of when and where bone marrow drives are occurring. The general criteria for becoming a donor include factors such as general health status, weight and age. Those who will generally not be able to serve as a bone marrow/stem cell donor include people with a history of severe heart problems, cancer, hepatitis, insulin dependent diabetes or HIV. Donors are screened for conditions that would put them at too great a risk to donate as well as for illnesses that could be harmful to the patient.

How are unrelated matches found? There are a number of bone marrow donor registries worldwide. The National Marrow Donor Program is one of the largest computerized registries and keeps an extensive database of potential donors.

Your transplant center contacts the registries to begin a preliminary donor search. There is no cost for a preliminary search. Charges for a formal search vary so check with your insurance company to find out what coverage is offered regarding donor searches. If you have questions about any part of the donor search process, speak to your doctor or transplant coordinator. Don't be in the dark about the status of your search.

It takes time to carry out a search and here is where patience is a virtue. Your treatment center manages this information and will inform you of the results. If you've been told there are potential unrelated donor matches for you, more time is required. A formal search begins to narrow down candidates. If a donor is located, willing and eligible, then final evaluation begins. If no suitable matches are found, other potential strategies need to be discussed with your doctor.

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Table of Contents

History

Introduction

Understanding the Process

Preparations for the Transplant

The Transplant

Pediatric Transplants

Emotional Considerations

The Role of Caregiver

Selecting a Caregiver

Costs

Insurance

Financial Aid

Conclusion

Glossary

Resource Listing

Books

Friends

 

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