What is Bone Marrow?

Bone marrow is a spongy tissue found within bones. All blood cells are produced within the bone marrow. To sustain the necessary levels of blood cells the bone marrow of an adult must produce about three million red blood cells and 120,000 white blood cells every second. All these cells originate from a small population of stem cells. Less than one in 5,000 of the marrow cells is a stem cell. As well as producing mature blood cells stem cells have the remarkable ability to reproduce themselves. This maintains the pool of blood forming stem cells throughout life.

Normal bone marrow produces three types of blood cells red and white cells, and platelets. Red blood cells contain a protein, called haemoglobin, which carries oxygen to the body tissues. Platelets circulate in the blood and are important following an injury, because they are involved in forming blood clots to prevent continued bleeding.

White blood cells, there are several different types, which co-operate to protect the body against infection with bacteria, viruses, fungi and parasites. One of the most important types of white blood cell, responsible for general defence against infection, is the neutrophil.

What is a bone marrow/stem cell transplant

Stem cell transplantation (SCT) is the term now used in preference to bone marrow transplantation (BMT). When a patient's bone marrow fails to produce new blood cells, for whatever reason, he or she will develop anaemia, be prone to frequent, persistent infections and may develop serious bleeding problems. Anaemia can be treated reasonably well with blood transfusions. However, white cells cannot be effectively transfused and the short life-span of platelets limits the effectiveness of platelet transfusions. If normal blood cell production cannot be restored, and the bone marrow failure is very severe, patients will inevitably die of infection or bleeding.

In order to restore blood cell production, a patient may be given healthy bone marrow/stem cells. These may be the patient's own bone marrow/stem cells which were collected either prior to the disease or before intensive treatment started. This is known as an autologous transplant or an autograft. If healthy stem cells cannot be obtained from the patient they may be from a donor (e.g. from a brother or sister or an unrelated person). This is particularly beneficial in eliminating malignant disease from the marrow. A relatively new source of stem cells is the blood from the umbilical cord and placenta of a newborn infant. However, the number of stem cells obtained this way is lower than that obtained from an adult donor. At present this form of transplant is mainly used for children.

Why are bone marrow/stem cell transplants needed?

There are three situations in which patients may require a stem cell transplant. Two of these relate to failure of the bone marrow to produce blood cells while the third offers an opportunity to cure an otherwise incurable inherited disease e.g. sickle cell anaemia disease in children. Bone marrow/stem cell transplants are predominantly used as part of the treatment for certain types of malignant diseases, mainly leukaemia, lymphoma or myeloma which involve the bone marrow. Of almost 18,500 stem cell transplants carried out in Europe in 1998, 13,750 (75%) were for leukaemia or one of the related blood cancers.

Over 95% of all donor transplants were performed for patients with leukaemia, lymphoma, or aplastic anaemia.

How do I register via the ACLT to become a potential bone marrow/stem cell donor?

By attending one of our registration drives.

Photo 1.

When you 1st arrive you will be given an application form and general literature about the donation process if found to match a patient. You will be asked to complete the entire form and to read a small section of information about the 2 donation procedures. On completion we will ask you to watch a powerpoint presentation about:

The ACLT

• What is a blood related cancer?

• Why it’s important to register as potential donors?

• What will happen if found to match a patient in need of a life saving match?

• The 2 donation procedures

• What will happen to the patient throughout the process?

This is followed by a Q&A’s session and then each person will be taken to a counsellor who will go through your application form with you, to make sure you are able to register and to answer any personal medical queries you may have. The Counsellor will then ask you to provide a small saliva sample. The saliva sample is taken so that we can determine your bone marrow tissue type. Its quick and its easy and only takes about 30 minutes to sign up and potentially save a life. 

That’s it! You are now registered.

Photo 2.

Your human leukocyte antigen (HLA) type is determined and entered onto one of the UK Registers. Your saliva sample is tested to determine its HLA type. The results are added to the computerised registry of potential bone marrow donors main computer, which is searched internationally on behalf of patients who need a marrow transplant.

How to donate Bone Marrow cells?

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You will be contacted if a preliminary match is found. If the computerised Registry indicates that your marrow may match any of the patients in need, your donor centre co-ordinator informs you of your status and arranges additional testing. A compatible match is identified. Further testing may indicate that your precise HLA-type is compatible with the patient.

Photo 4.

Counsellors provide you with detailed information about the marrow donation process and your options as a volunteer donor. You will also receive a thorough physical examination.

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You decide whether to donate. After being fully informed about the donor experience, you make the decision -- with the support of your friends and loved ones to become a marrow donor.

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A small amount of your marrow is collected. In the hospital/clinic, marrow is taken from the back of your pelvic bone using a special needle and syringe. You are under general anaesthesia during this simple surgical procedure. You recover quickly from the procedure. Typically, you stay overnight in the hospital.

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After being discharged, you can resume normal activity, although you may experience some soreness for several days, a week or slightly longer. Your marrow naturally replenishes itself within a few weeks.

The alternative method is to donate Stem Cells. It’s called Peripheral Blood Stem Cell Donation (PBSC), Peripheral Blood Stem Cell Donation (PBSC). Unlike Bone Marrow, Stem Cells can be removed without using a general anaesthetic.

Blood cells tend to recover more quickly with a Stem Cell transplant than a Bone Marrow transplant, so you are at risk of infection for a shorter time. To collect the Stem Cells from the blood, you will be given injections of a growth factor—a protein that stimulates the bone marrow to produce lots of immature, normal cells. These spill over into the blood and can be collected. Collecting Stem Cells takes 3-4 hours. You will be sitting down on a hospital bed relaxing, with a drip placed into a vein in each arm. Blood is taken through the drip to a blood cell separator, where it is spun to separate out the Stem Cells. Your blood is then returned to you through the vein in your other arm.

Photo 8.

5 days prior to a Peripheral Blood Stem Cell donation the donor is given a hormone booster jab to saturate the bone marrow with the required Stem Cells

Photo 9.

Stem Cells collected as outpatient on a blood cell separator machine. Post treatment flu like symptoms and slight discomfort, return to normal 1-2 days.