Bone marrow and stem cell donation

Who is it for?

A stem cell transplant is used in some blood cancers and in diseases that disrupt blood production. Examples:

• Leukemia (blood cancer) and lymphoma (cancer of the lymph nodes)
• Multiple myeloma and myelodysplasia
• Bone marrow failure, such as aplastic anemia
• Inherited blood diseases such as thalassemia and sickle cell disease
• Some severe immune deficiencies and inherited metabolic diseases

A transplant is not right for every patient; the patient's doctor makes the decision.

HLA is a cell marker that lets the immune system tell its own tissue from foreign tissue. Because it is inherited from the mother and father, a match is most often found among brothers and sisters and among people of similar ancestry. According to NMDP, the donor registry organization in the US, about three in four patients do not have a fully matched donor in their family; this is why a large pool of volunteers is important.

According to the current pages of TÜRKÖK and Türk Kızılay, healthy people aged 18–35 who do not have a serious or infectious disease and have never been diagnosed with cancer can become volunteer donor candidates.

How does it work?

To register, you apply to the stem cell donor center nearest to you or to one of Türk Kızılay's permanent blood collection centers. The process is roughly as follows:

• You fill in a consent form, and a doctor examines you
• 3 tubes of blood are taken for blood group, infectious disease tests (HIV, hepatitis B and C, syphilis) and tissue typing
• If the tests are suitable, your tissue type is recorded in the TÜRKÖK database and regularly compared with patients
• If there is a possible match, Türk Kızılay calls you; the tissue match is confirmed with a new blood sample
• Then a detailed examination, an ECG, a chest X-ray, blood and urine tests, and a pregnancy test for women are done

The patient's doctor decides on the collection method based on the patient's needs and your health; your preference is also taken into account.

Peripheral blood stem cell collection is the most commonly used method. First, for a few days, you are given injections under the skin of a growth factor that moves stem cells from the bone marrow into the blood. Then blood taken from one of your arms is passed through an apheresis machine; the stem cells are separated, and the rest of the blood is returned through your other arm. The procedure takes about 4–5 hours; no hospital stay or anesthesia is needed.

Bone marrow collection is done under general anesthesia. Marrow is taken with a special needle from the back of the hip bone; no stitches are needed. You usually go home the same evening or the next day.

According to TÜRKÖK, the donation process is spread over 4–6 weeks on average and takes a total of 20–30 hours of your time.

Afterwards

With the peripheral method, muscle and bone pain, tiredness, headache, mild fever and flu-like weakness are common while the injections continue; you may feel fullness in the area of the spleen. According to TÜRKÖK, these go away within 48 hours after the donation.

After bone marrow collection, you may have pain and stiffness in the hip, tenderness at the needle sites, tiredness, and a temporary sore throat or headache due to the anesthesia. For the first 2 weeks, do not lift heavy things or do strenuous exercise.

Many donors return to their daily activities within a few days. According to TÜRKÖK, the side effects are not permanent and usually go away in 1–3 weeks. Stem cells renew themselves; their numbers return to their previous level over time.

Do not choose a pain reliever on your own; some affect blood clotting, so ask the donation center. TÜRKÖK has your health checked again within the first month. Your registration is kept inactive for 1 year after the donation.

In Türkiye

TÜRKÖK (the Turkish Stem Cell Coordination Center) is part of the Turkish Ministry of Health (Sağlık Bakanlığı). It runs the bone marrow registry that holds the tissue information of volunteers and patients, and it coordinates between transplant centers.

TÜRKÖK has been a member of the World Marrow Donor Association (WMDA) since 2016; so you may also be matched with a patient abroad. In that case, too, the collection is done in Türkiye and the cells are sent to the patient's country.

The donor is not asked to pay, and the donor's social security coverage is not used. If your address or phone number changes, tell Türk Kızılay. Your identity is kept confidential; direct contact with the patient is possible only 2 years after the donation and only if both sides want it.

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