Frequently Asked Questions

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How are stem cells donated


PERIPHERAL BLOOD STEM CELL COLLECTION

 

This is the most likely method of collecting your stem cells. Blood stem cells are found in the bone marrow and also in the circulating blood stream (peripheral blood) but in smaller numbers. A growth factor known as granulocyte-colony stimulating factor (G-CSF) occurs naturally in the body and regulates the production of granuloycytes and stem cells. Neupogen, which is a man-made form of G-CSF, is injected daily for five days prior to the collection. This temporarily boosts granulocyte production and encourages movement of the stem cells from the bone marrow where the cells are made, out into the peripheral (circulating) blood.

faq_howThe stem cells can be collected from the peripheral blood by an apheresis machine, also called a cell separator. This procedure, which can be uncomfortable, entails you being connected to the machine by an intravenous line (similar to donating platelets). Your blood is circulated through the apheresis machine, which removes the stem cells from your blood. The cells that are not required are returned to your circulation. Peripheral Blood Stem Cells are equally efficient and comparable to bone marrow for the recipient and are considered to be much less trouble for the donor.

One or two collections on consecutive days, each lasting 4-6 hours, may be required. Overnight hospitalisation is not usually necessary except when a central venous catheter (an intravenous line placed into a vein in your groin [femoral vein]) has been used to enable easy access to your blood circulation or when a two day collection is performed. A general anaesthetic is not required for the procedure either. The effects of G-CSF may include headache, bone pain and flu-like symptoms during the 5-day period the drug is being administered, but these symptoms usually recede 1-2 days after the last dose of the drug.

During the collection procedure, the donor may experience discomfort at the sites of the needle insertion and a temporary tingling sensation in the body from the anticoagulant used to keep the cells from clotting. No extended recuperation period is usually necessary, although you may feel tired for a few days afterwards.

NOTE: There are no costs involved for you, the donor. Reimbursement of reasonable costs incurred by the donor is possible. The SABMR covers the costs of further testing as well as harvesting of the stem cells

IMPORTANT INFORMATION FOR PROSPECTIVE STEM CELL DONORS

When donors are identified as being a match for a particular patient and agree to donate peripheral blood stem cells, they will be given injections of Neupogen, a synthetically prepared form of naturally occurring granulocyte colony stimulating factor (G-CSF). It is given in order to mobilize the stem cells out of the bone marrow and into the circulating blood, where they can be collected for a patient needing a transplant.

Normal individuals are at risk for developing cancer, including leukaemia, lymphoma or other blood diseases throughout their life time. G-CSF stimulates normal blood cell growth. In some patients with cancer or abnormal blood cells, it has been shown to stimulate leukemic blood cells.
However, studies following large numbers of unrelated donors have shown that the risk of developing cancer within several years after the use of G-CSF is not increased compared to donors not receiving G-CSF. To read the full version of the G-CSF statement issued by the World Marrow Donor Association, please click here.

Who do we need as donors?

Every healthy person between 18 and 45 can be a donor. “Tissue-types” are inherited characteristics, used in matching donors and patients. The likelihood, therefore, of finding a suitable volunteer will be considerably greater within the same ethnic background. Accordingly all racial groups are welcome.

What is the South African Bone Marrow Registry?

An organisation that registers potential bone marrow donors and already has 64 000 participants. It was started in 1991 and has been designated as the Hub centre for this Continent. As such, we are responsible for coordinating the provision of unrelated donors for our patients in association with a world wide database of >20 million donors and cord blood units.

Why do people need bone marrow transplants?

Every year thousands of individuals with blood diseases such as leukemia, marrow failure or aplasia, and inherited metabolic and immune deficiency syndromes reach a stage where only this procedure offers a chance of cure.

Why are unrelated donors needed?

Family members, particularly brothers and sisters are generally most suitable. However, due to the average family size, only about 30% of patients have a compatible sibling.

How do bone marrow transplants save lives?

The patient’s diseased marrow is destroyed by combinations of cytotixic drugs and radiation. The graft from the healthy donor is given intravenously. Thereafter the blood forming stem cells travel to cavities in the large bones and, following engraftment, begin producing normal blood.

What is bone marrow?

This is the tissue that could be regarded as the factory for the production of red cells to carry oxygen, white cells to fight infection and platelets to prevent bleeding.

How are donors and patients matched?

In the same way as red cell blood groups exist, so white cells can be categorised into groups known as “tissue-types”. Very many possible tissue types exist, so that finding the correct match depends upon having a very large register of volunteers. Although there are over 10 million donors registered worldwide some searches are still not successful.

What does the donor initially do?

Volunteers, if deemed to be suitable, need to have a small blood sample taken and sent to our laboratories for tissue-typing. The results are placed on an international computer registry.

What happens next?

Possible matching donors will be asked to provide further blood samples to help select the donor matches best for a particular patient.

Can I change my mind?

You are completely free to change your mind at any moment, up to the moment you are asked to donate. Most donors are delighted to hear that they have been chosen to donate – after all, that’s why they joined the Registry.

Where would I donate?

The medical procedure for obtaining stem cells is called a harvest. If you are asked to donate you would be required to attend a specialist harvest centre in South Africa.

Is a transplant a definite cure?

Unfortunately the field of bone marrow transplantation is complex and a number of patients still die of complications despite the best medical care. Increasing numbers of successful transplants are being carried out using matched unrelated donors. However, donors can only be assured that they offer the hope of a future to patients whose disease would almost certainly otherwise prove fatal.