Why Living Bone Marrow Donation?
Bone marrow is a soft material in the center of bones responsible for producing red and white blood cells as well as other components of blood.
Bone marrow transplantation is used in treating several diseases or for counteracting the effects of the treatment of diseases such as chemotherapy. That is, bone marrow transplantation is not intended to replace the patient’s failing bone marrow. Instead, the donated marrow is used to help a recipient produce components of his or her blood compromised by disease or by the treatment of certain diseases, such as cancer.
Examples of diseases treatable through bone marrow transplantation include:
- Hodgkin’s and non-Hodgkin’s lymphoma,
- Aplastic anemia,
- Sickle cell anemia, and
- Combined immune deficiency.
In some cases, there is no alternative to bone marrow transplantation, which makes donation especially important.
We don’t have the wealth of statistics on bone marrow donation like we do for whole organ donation. But we do have an indication from the National Marrow Donor Program® that unrelated donations number 1,000 or more per year, with related donations as many as five times higher.
Unrelated donation has always been important because bone marrow donation is especially sensitive to the matching of donor and recipient antigens. These transplants are subject to rejection like whole organs, and there is also the risk of “graft versus host” disease where the donated marrow actually attacks the cells of the recipient. Consequently, a perfect match of human leukocyte antigens (HLAs) is preferred. Unfortunately, it’s not easy to find a perfect match even among family members. Therefore, the availability of unrelated donors who have had tissue typing is vitally important.
Because tissues types are inherited, matches are more likely from people of the same ethnic and racial background. Therefore, several registries in the U.S. have been formed for specific groups, such as These organizations encourage donation, sign up potential donors, record information on HLAs for tissue-type and blood-type matching, and match donors to patients.
There are also national marrow registries in the US, including the National Marrow Donor Program and the American Bone Marrow Donor Registry. As an example, the National Marrow Donor Program maintains the names of more than 8 million volunteer donors.
The World Marrow Donor Association has been formed to establish guidelines for international bone marrow and blood stem cell transplantation where the donor is in one country and the recipient is in another. While this organization, based in Leiden, The Netherlands, does not maintain its own registry, it does establish standards for registries.
The first step in being a volunteer bone marrow donor is to sign up with one of the registries, the process for which is described in the next section.