FAQ for Donors
What is bone marrow?
Bone marrow is contained inside the hollow spaces of our major bones. It looks like blood except it contains stem cells which are capable of producing red and white blood cells and platelets. These are the main components of our blood and for most patients, they have a disease which means their bone marrow is not capable of producing healthy blood cells or the right combination of blood cells.
Who can be a donor?
Anyone between the ages of 17 and 49 can sign up as a bone marrow donor. You need to be in good health and you can apply online for a postal kit to be sent to you and all you need to do is a simple cheek swab.
Are Muslims allowed to be donors?
Yes you are allowed to be a donor and in Singapore, the Islamic Religious Council has issued a Fatwa giving approval for all Muslims to be bone marrow donors and help save the lives of patients who need a transplant.
What happens if I come up as a match?
See the section You are a Match.
What if I am unwell when you call?
It usually takes a few weeks from the first call until the date of actual donation and during this time you would have recovered from a typical flu or other virus. You will also have a full medical check up as part of the Donor Workup and the doctor who is looking after you would decide if you are unfit to donate.
What happens if a donor is pregnant?
Women are not allowed to donate bone marrow during pregnancy and for 12 months after giving birth. You would automatically be withdrawn from the register for this time period.
If I come up as a match, do I have to pay any expenses?
No, you will not. You will be reimbursed for all expenses relating to the bone marrow donation including any travel expenses or unpaid leave although most employers are very supportive and will allow additional time to attend medical check ups. For the donation itself you will be given 2-3 days medical leave to make sure you get adequate rest. Throughout the whole process, our BMDP Donor Centre Coordinator will be with you to help set up appointments, answer your questions and generally be your liaison.
Can I say “No”?
A volunteer donor who is successfully matched with a transplant patient may decide not to go ahead with the process. There are legitimate reasons for saying “no”, including illness, the risk involved or even fear. While the BMDP respects the decision of the matched donor, uncommitted donors give false hope to patients awaiting transplants. Once a donor gives his or her consent on the “Intent to Donate” form, the patient actually begins pre-transplant treatment where his or her bone marrow is completely being wiped out. So when a donor decides to pull out at any stage after the endorsement, the patient will most likely die without a transplant as his or her own bone marrow has been wiped out. The BMDP hopes that you will be committed to your participation as a bone marrow donor.
Are there any risks or side effects?
What are the side effects?
Bone Marrow donation
Donors generally feel no pain during the bone marrow harvest as the procedure is carried out under general anaesthetic. Some donors may feel nauseous for a few hours afterwards due to the anaesthetic and may have bruising and/or local discomfort but generally, these symptoms will pass within a week or so.
The side effects of G-CSF may include flu-like symptoms such as headache, bone and muscle ache but they are usually mild and last just a couple of days. Other common side effects include nausea, trouble sleeping and tiredness. During the donation itself, some donors may feel lightheaded or have chills, numbness or tingling around the mouth and experience hand cramps. These normally go away immediately after the donation.
What are the risks?
PBSC and BM donation are extremely safe procedures. However, like all medical procedures, they have some inherent risks.
Bone Marrow donation
Possible complications include allergic reactions to anaesthetic, infection and injuries at the harvest site.
For this type of donation, a catheter must be placed into the donor’s arm. However, if these veins are too small, a larger vein in the neck, chest or groin can be used. This rarely causes complications but there are additional risks to be aware of, including increased risk of infection, bruising and bleeding and the possibility of pneumothorax.
Donors often ask about G-CSF and any long-term health risks. G-CSF is a naturally-occurring hormone which increases the number of stem cells the body produces.
To date, the World Marrow Donor Association (WMDA) is unaware of any long-term complications directly associated with G-CSF given to healthy stem cell donors.
What exactly is a Marrow / Stem Cell Transplant?
It is the replacement of diseased marrow with marrow from a healthy donor. The recipient will first undergo a pre-transplant “conditioning” treatment where his or her own bone marrow is completely destroyed so that the new marrow can engraft. The bone marrow or stem cells are infused into a patient’s vein just like a blood transfusion and they have a unique ability to migrate to the spaces in the bones. Within two to three weeks, the transplanted marrow/stem cells will begin to produce normal blood cells and platelets.
When do I become a Bone Marrow Donor?
Your tissue type has to match perfectly with that of the patient’s. The odds vary widely, depending on the rarity of the patient’s tissue type. However, once you are identified as a compatible donor, you may be the only person who can provide the life-saving bone marrow to that patient.
How is bone marrow collected from a donor?
Upon identification as a compatible match, the donor will be counselled before undergoing a thorough medical examination to ascertain his or her fitness level. Currently, there are two standard methods to harvest the bone marrow.
Method 1: Bone Marrow Harvest
The bone marrow is removed from the back of the pelvic bone using a special needle. The entire process takes 45 to 60 minutes whilst the donor is under general anaesthesic (GA). Although there is no surgery involved, after a GA it is recommended that the donor stays overnight to rest in the hospital and goes home the following morning. The amount of bone marrow harvested is less than 5% of the body’s marrow and this is naturally regenerated within 4-6 weeks.
Method 2: Peripheral Blood Stem Cell Harvest (PBSC)
Peripheral Blood Stem Cells are those blood cells that are usually found in the blood stream. The donor will be given 4 daily injections of a hormone called G-CSF (Granulocyte-Colony Stimulating Factor) to stimulate the growth of their stem cells and to mobilise them into the blood stream. This is usually done in the morning and the donor can continue their normal daily activities. On the fourth day, the stem cells will be collected in an outpatient procedure that is very similar to blood donation except that it will take between 5-7 hours. Once complete, the donor is usually free to go home.
Who needs a Bone Marrow Transplant?
Bone marrow transplants are used to treat patients whose bone marrow stops producing the correct amount of various blood cells. More than 60 potentially fatal diseases, including several types of leukaemia, are treated with unrelated bone marrow transplants.
What is the source of the G-CSF growth hormones?
Granulocyte colony-stimulating factor (G-CSF) is a natural substance produced by the body in time of infection. It is used to stimulate the production of blood stem cells. A man-made G-CSF derived from the E coli bacteria is used for peripheral blood stem cell harvesting.