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.
Why is there an age limit?
Patients especially need donors who are between the ages of 17 and 49. The age limit is meant to protect the safety of the donor and provide the best possible outcome for the patient. That’s because younger donors produce more and higher-quality cells than older donors.
The upper age limit is based on both donor and patient considerations. There is a small increase in the risk of complications from donations in older donors.
Is the match by blood group? Why is it so hard to find a match?
Matching donors and patients are much more complex than matching blood types. Doctors match donors to patients based on their human leukocyte antigen (HLA) tissue type. HLA are proteins, or markers, found on most cells in your body. Your immune system uses these markers to recognise which cells belong in your body and which do not. A close HLA match between donor and patient is the most important matching factor.
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.
Why is there a country of origin criteria?
Foreigners wishing to sign up to the Singapore Bone Marrow Donor Register can only do so if they are from a country that also has a Register so that the BMDP can get in contact with them once they return to their own country.
What happens if I come up as a match?
See the section You are a Match.
What if I don’t think I’m well enough to donate when I’m called up?
Following your information session with the Donor Coordinator, your appointed doctor will complete a donor health questionnaire and evaluate you and your family’s medical history.
Next, you will be given a thorough physical examination to make sure you have no pre-existing medical conditions that could pose any special risks to you or the patient. We will also collect blood samples to be tested for infectious diseases. This is very important as some diseases can be transmitted to a patient through donation and the results will help determine your eligibility. The entire process will take about 2 to 3 hours.
Is there any minimum weight to donate bone marrow?
Our policy states that donors should be above 45kg. However, each donor is assessed individually so you may be cleared to donate. All these will be further discussed in the info session with the Donor Coordinator.
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 for you to attend medical check-ups. For the donation, 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.
I think I’ve registered as a donor already, but I’m not sure. How can I check?
Please drop us an email at firstname.lastname@example.org and provide us with your full name and NRIC so that we can check the database.
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 “risks” involved or even fear. While the BMDP fully 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 will begin 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?
Can I choose which method of bone marrow donation I prefer?
Yes, donors can indicate their preferred method and they will be advised of the transplant doctors’ preference as well based on the needs of the patient as well.
What are the methods of bone marrow donation?
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 anaesthetic (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 bloodstream. This is usually done in the morning and the donor can then continue their normal daily activities. On the fourth day, the stem cells will be collected in an outpatient procedure similar to blood donation except that the donor is connected to a machine that draws his blood out, selects out the cells needed, and returns the rest of the blood to him. The process takes between 5-7 hours. Once complete, the donor is usually free to go home.
How long is recovery time?
Marrow and PBSC donors should expect to return to work, school and most other activities within 1 to 7 days. Your marrow will return to normal levels within a few weeks.
I have a friend in xxx country and he/she is unwell...
It is important to know that every request we receive at the BMDP to find a match for a patient will start with a search of the local donor register and then extend as necessary around the world. As a member of Bone Marrow Donors Worldwide (BMDW), we are connected to stem cell donor registers in more than 48 countries which give us immediate and real-time access to 20 million donors.
For example, if the friend is in Korea, her doctor-in-charge would evaluate her condition and make an assessment on her condition to see if a transplant is needed. If a transplant is required, the doctor will activate a search through the Korean registry to see if there is a matching donor.
If there is no matching donor, the Korean registry will then seek the help of international registries. When a match is found, they will liaise with the registry to see how they can collect the stem cells.
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.
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.