askthedoctor Marrow Donation F
Help Meet the Need A large pool of poten- tial donors is critical to finding the best pos- sible match for a specific individual. The National Marrow Program is a federally funded program supporting the “Be The Match” registry (https://
bethematch.org).
48 MILITARY OFFICER MAY 2017
A bone marrow transplant might be the last option to save someone’s life. But these life-saving transplants are only possible when there are donors. By Rear Adm. Joyce Johnson, D.O.
For people with certain blood-related cancers and other diseases, a bone mar- row transplant can be a life-saving treat- ment option. Bone marrow and peripheral blood contain hematopoietic (blood-form- ing) stem cells. These develop into cells that make white blood cells (to fi ght infection), red blood cells (to carry oxygen to all parts of the body), and platelets (for clotting). Anyone requiring a bone marrow trans- plant is seriously ill, and treatment is ag- gressive. First, immediately before the transplant, the patient’s immune system is medically destroyed with drugs and some- times radiation. This kills not only abnor- mal cells responsible for disease but also normal cells. Then, donor cells are trans- planted; if the transplant is successful, they will grow and produce healthy blood cells. A close tissue type match is important for a successful outcome. At any given time, about 6,000 patients in the U.S. are wait- ing for a donor match. Two random people have about a 1 in 20,000 chance of having the same tissue type. In the U.S., the donor registry includes over 14 million potential donors. Though most will never be called to donate, more are needed to assure the best matches. Consider joining a registry if you are 18-60 years old (preferably 18-45) and are generally healthy, without any autoim- mune or other immune disorders, chronic infectious diseases, or cancer. The fi rst step to joining a registry is to complete a questionnaire. The second step is testing your DNA, which is collected by
rubbing a cotton swab on your cheek inside your mouth. A cheek swab can be done dur- ing a donation drive, at some medical cen- ters, or with a mail-in kit at home. The next step is to wait. It takes about three to 10 weeks to be entered into a registry, and then it can be months or years until you are iden- tifi ed as a possible match — if you ever are. If you are identifi ed as a candidate donor for a specifi c patient, you will have to pro- vide a blood specimen for confi rmatory testing. If a match seems likely, the entire donor process will be clearly explained, and an additional work-up will assure you are in good health. Donated bone marrow can be collected from the pelvic bone, in what is usually an outpatient procedure, or fi ltered from your peripheral blood (collected and returned through an IV line). Either pro- cedure usually involves a week or less off work, and registries try very hard to accom- modate donor schedules. A donor’s cells regenerate, so there’s no
lasting impact on a donor’s blood or im- mune system. Medical costs are paid by the registry and/or the recipient’s insurance. Most employers pay lost wages, as will some registries. The identities of a donor and recipient usually are maintained confi - dentially; sharing information requires the consent of both patient and donor.
MO
— Rear Adm. Joyce Johnson, USPHS (Ret), D.O., M.A., is a health care consultant in Chevy Chase, Md. Find more health and wellness resources at
www.moaa.org/wellness. For sub- mission information, see page 4.
PHOTO: STEVE BARRETT
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