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Stem cell, bone marrow transplants increasingly easy, common

Would-be donors can register, be ready in case of a match

By Howard Buck
Published: April 18, 2010, 12:00am

Donating blood stem cells or bone marrow to assist patients fighting blood or immune disorders has never been easier, or more popular.

New medical procedures and spread of the Internet have led to a surge in successful transplants and much simpler, less invasive donations.

“It’s not bad at all. People are very altruistic, and they do this,” said Liz Hopper, director of clinical services at the Puget Sound Blood Center headquarters in Seattle.

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Odds of a patient locating a good match range from 60 to 80 percent, depending on race, experts say.

Stem cells and marrow must be very fresh, and be shipped within hours to patients by courier. So donations come only at the time an identified patient is ready. (By comparison, normal donated blood has a shelf life of 42 days; blood platelets, five days.)

The first step for potential donors is to register with the National Marrow Donor Program.

Go to http://www.bethematch.org or http://www.marrow.org; or call 1-800-627-7692 (that’s 1-800-marrow2).

Healthy donors age 18 through 60 who meet all qualifications may register.

They will be mailed a testing kit, and return a mouth swab so their sample can be scored across the grid of markers that identifies a true match.

A match of six HLA (or human leukocyte antigen markers) is considered “perfect.”

A qualified regional donation center would contact the donor when a matching patient is identified.

Stem cell donations have quickly become the preferred method to restock blood cells and restore damaged immune systems.

Each donor is given a new physical checkup, then receives special injections four consecutive days (from a local health care provider) to boost the circulation of stem cells.

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On the fifth day — and this is only at a regional blood center equipped for stem cell and marrow donations — the donor undergoes apheresis.

By tapping a vein, the donor’s blood is recycled, passed through a device that sifts out stem cells with a centrifuge. It’s a pain-free process that lasts four or more hours, depending on stem cell volume and body weight (need) of the patient.

Typically, about 200 cubic centimeters to 250 cc of material — tens of thousands of blood cells — is collected, then rushed for a transplant.

Donors may feel mild, flu-like aches and pains during the injection cycle, easily tempered with normal medicine. The actual donation is painless, and donors should feel perfectly normal within a day or two.

In some cases, physicians may call for bone marrow.

There are no prior injections required. Instead, several needle sticks into the donor’s hipbone are used to extract marrow, over about 45 to 60 minutes, which likewise would then be rushed to the patient.

Marrow donors usually are somewhat sore for a few days, with no other lingering effects.

About 8 million people in the U.S. are registered donors; there are 13 million donors listed worldwide. That includes about 68,000 Washington residents, Hopper said.

Actual transplants to patients in the U.S. number about 4,000 per year, but continue to rise. The national registry reports a record 500 transplants in March.

Washington’s regional Puget Sound Blood Center in Seattle recorded about 35 stem cell or marrow donations last year, Hopper said.

While chances are good for patients seeking a match, few volunteers are called: For each donor, odds of a match are about 1-in-200, experts say.

Howard Buck: 360-735-4515 or howard.buck@columbian.com.

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