KU doctor explains need for bone marrow donors and how process works

How to help

A Marrowthon will take place from 8 a.m. to 3 p.m. Friday in Lawrence Memorial Hospital’s auditorium, 325 Maine.

No fee will be charged for the first 32 prospective donors. The fee will be $25 — about half the normal cost — for everyone else.

There will be an informational area. To get a sample, health professionals will rub the inside of your cheek with a swab. The process should take less than 30 minutes.

If you can’t make the Lawrence event, you can sign up online to be on the national registry.

Lawrence Memorial Hospital is having a bone marrow registry drive on Friday.

For thousands of people with leukemia, lymphoma and other life-threatening diseases, a transplant offers a second chance at life.

Every day, more than 6,000 patients search the national registry for a life-saving donor because a match could not be found in the family.

Despite the 7 million people on the registry, the chances of finding a match are not guaranteed.

According to Michelle Setterholm, director of scientific services for the National Marrow Donor program, the chances of finding at least one potential match is:

• African American, 59.5 percent.

• Asian/Pacific Islander, 78.1 percent.

• Hispanic, 80.5 percent.

• Native American/Alaskan Native, 81.7 percent.

• Caucasian, 87.6 percent.

Those percentages represent the potential matches that you would get from running a search of the Be The Match registry, which is operated by the National Marrow Donor Program.

The numbers are based on the number of people who are registered and how many people have searched during the past 20 years. For example, 322 Native Americans/Alaskan Natives looked for a potential match in 2004, compared with 61,527 Caucasians.

Setterholm said while the odds may look good, the key word is potential. The numbers go down as a magnifying glass is placed on each match. The numbers don’t represent the final match and those percentages are not available. Setterholm estimates that they would be a “lot, lot, lot less.”

“The bottom line is that we don’t have enough donors so that, when you are looking under the magnifying glass, everybody who is searching gets a transplant,” Setterholm said.

There are women, men and children who die because they don’t find a match. On average, a patient waits about 87 days to find a match.

“That’s a problem because these patients have aggressive diseases and a significant percentage of patients — even if they have a match — do not make it to the transplant because their disease is progressive. They need to get treated right now and three months is a long time for them to have to wait,” said Dr. Joseph McGuirk, medical director for the Blood and Marrow Transplant program at Kansas University Cancer Center. “So, patients can and do die of leukemia while they are waiting on a donor.

“This recruiting effort you are doing in Lawrence and those types of efforts throughout the country are steadily picking away at this timeframe.”

How it works

How can individuals help? First, sign up to be on the Be The Match registry if you are between the ages of 18 and 60 and in good health. This requires paperwork, a fee, and a swab from the cheek.

To sign up, visit Lawrence Memorial Hospital between 8 a.m. and 3 p.m. Friday or visit this Web site.

If an individual is a match, her or she receives a phone call and is informed that there is a patient who might benefit from a bone marrow transplant. They can either accept or decline to donate. Then, the donor visits a doctor and has more blood drawn to see if they are indeed the perfect match.

Once that is confirmed, then they have a chest X-ray and physical examination.

“Once all of that is cleared, then we are ready to move full steam ahead,” McGuirk said.

There are two ways to collect stem cells from a donor.

Bone harvest

One, and the most common way, is to do a bone marrow harvest. This is where the donor is given a general anesthetic and the stem cells are collected from the back side of the pelvis with needles. McGuirk said doctors usually take between a quart and a quart and a half of bone marrow.

The donation is shipped wherever in the world it is needed and as quickly as possible.

“Even if it is in Europe or Asia, we try to get it there in 24 hours to the recipient,” McGuirk said.

The donor likely will be sore for a week.

“They are going to feel like a mule kicked them in the back end and we give them medications for that. Most of them are back to work in several days to a week,” McGuirk said.

Other minimal risks include needing a blood transfusion, so donors often are asked to donate blood before the procedure. There’s also a small chance that an infection might develop at the general harvest site. There’s always a risk when someone is given an anesthetic.

Filtering blood

The second option is to have stem cells collected from the blood. McGuirk said stem cells normally don’t circulate in the blood, but doctors can give individuals a drug that causes the stem cells to break loose from the bone marrow and circulate in the blood in large numbers. The drugs are injected daily over four days, and then the patient is hooked up to a machine and donates intravenously while watching television, taking a nap or eating lunch. The stem cells are separated from the rest of the blood and the remainder of the red blood cells and platelets are returned to the patient. The process takes about five hours.

McGuirk said the shots can cause pain and joint aches, but the donors usually take Tylenol for it.

“For the patient, we don’t know which is the superior stem cell source,” McGuirk said.

KU Cancer Center is one of a number of centers nationwide that are participating in a clinical trial to determine which process is better for the patient. The study was started about three years ago and should wrap up in the next six months, McGuirk said.