Questions and Answersabout

Bone Marrow Stem Cell Transplantation

prepared by the Armenian Bone Marrow Donor Registry

What is the connection between blood and bone marrow?

Blood cells live and function for a few weeks,

then they die, and have to be replenished Stem cells in the bone marrow are the source of

red blood cells, white blood cells, and platelets

How do bone marrow stem cells help certain patients?

Patients with some blood illnesses make blood cells that are damaged and defective

This is due to defective bone marrow stem cells Replacing their bone marrow stem cells with new

and healthy ones allows them to have a continuous supply of healthy and functional blood cells

What are the most commonblood related illnesses?

Malignant Different types of Leukemia (AML, CML,etc.) Lymphoma

Non- malignant Aplastic anemia Genetically inherited anemias Fanconi anemia

What is the usual treatment?Chemotherapy and Radiation therapy:

Destroy cancerous cells patient goes into remission

Potential problemsSide effects: treatment may destroy healthy cellsRelapse: sometimes the cancer returns

Stem cell transplantation:

Establish healthy stem cells in the patient’s bone marrowHealthy stem cells produce healthy blood cells

What is required for a transplant?

Bone Marrow Stem Cells From volunteer donors

Can anyone be a donor?

Yes, but with some restrictions:Age: between 18 and 50

Health: generally healthy

(no cancer, cardiovascular disease, HIV, infectious diseases, hepatitis, etc.)

Can any donor donate to any patient?

Yes

Provided their transplantation proteins (HLA) match

What is HLA?

It is a set of proteins that:Characterizes the tissue of each person Is determined by each person’s genetics

and is inherited from both parents Is unique to each individual —much like

a fingerprint

Who are the best candidates to match patient HLA type?

1. Self (in some diseases)2. Identical twin3. A sibling sharing both parents4. Unrelated individual from the same

ethnic group (even better if from the same region)

Why are donors from the same ethnic groups more likely to be a

better match?

Members of the same ethnic group are genetically closer to each other

Therefore, they are more likely to have the same HLA profile

Rejection

The patient’s immune system

attacks and destroys the transplant

What happens if donor and patient are not well matched?

Graft vs Host Disease (GVHD)The transplanted tissue attacks and destroys the patient

How does one become a donor?

Three simple steps:

Fill out a short form-strictly confidential (this becomes your official consent form)

Donate a small sample for tissue typing Donate stem cells when matched with a patient

What is in the form to fill out?

Your address and contact information Your brief medical history

(all info in these forms is strictly confidential)

How to donate a sample for HLA typing?

Mouth swab The inside of your cheek is swabbed to obtain some

tissueor

Blood sample A very small amount of blood (few drops) is collected

from a vein

What is done with the collected sample?

DNA is extracted from the sample DNA is analyzed for transplantation proteins

(HLA type) HLA type is entered in our data base (with full

information about donor) The database is the ABMDR registry The database is safe and strictly confidential

What if a donor matches a patient?

The donor’s DNA is tested further for higher level of matching with patient

If donor matches 100% and is able to donate: undergoes extensive medical checkup if fit, becomes an actual donor

What is the procedure of an actual donation?

The donor is given a stimulant to increase the number of stem cells circulating in blood

S/he is hooked up to an IV in each armBlood is drawn from one armStem cells circulating in blood are separated

and collected via an apheresis machineThe blood is returned to the donor via the IV

in the other arm

You mean this does not involve my spine?

Correct Bone marrow stem cells

reside in the spongy part

of the hip bone But some also circulate in blood.

These cirulating stem cells are

the ones that are harvested

spongybone(containsmarrow)

compactbone

cartilage

A donor in the process of giving herbone marrow stem cells

An apheresis machine used for harvesting stem cells

Where and how is the “harvesting” performed?

In the nearest hospital or facility equipped for the procedure (including ABMDR’s Harvesting Center)

On an outpatient basis

Is there any surgery involved?

No

The donor is not even anesthetized

S/he is fully conscious and awake

How long does it take to “harvest” the stem cells?

3-4 hours

Are there any risks or adverse effects to the donor?

No, it is a simple procedureIt is painlessOnly excess stme cells are harvestedThese cells are replenished within 2-3 weeks

Some donors experience mild flu-like symptoms for a few days (the effect of the booster treatment)

Are there any costs incurred by the donor?

No Tissue typing costs are covered by

ABMDR Stem cell harvesting costs are

covered by the patient’s insurance

Los Angeles: 323-663-3609 abmdrla@abmdr.am

Yerevan: (374 10) 20 83 11 info@abmdr.net

Armenian Bone Marrow Donor Registry www.abmdr.am

Who can I contact to become a donor or to have my questions answered?

Save a life

Be a donor