Finding a Donor for Bone Marrow Transplant

Overview

If you and your hematologist have decided to use someone else's stem cells for the bone marrow transplant, identifying a suitable donor is the next big step in the process.  Since our bodies can tell the difference between foreign cells from our cells, the donor’s stem cells should be compatible. This is crucial to prevent the occurrence of graft vs host disease. The complications of a mismatch can be severe and may require medical attention.

How is a Suitable Donor Identified for My Mone Marrow Transplant?

HLA Typing 

A match between the donor and the patient is made based on the results of HLA typing.

HLAs or human leukocyte antigens are proteins on the surface of white blood cells. This marker makes our tissues unique. These proteins help to differentiate the foreign cells from our own. HLA typing is done after obtaining a blood sample.

A good match lowers the risks of complications such as organ rejection.  We have knowledge about  600 HLA molecules. Half of these are inherited from the mother and half from the father. Thus, your brother or sister from the same parents has a 25% chance of being an HLA match.

Once your hematologist has determined that you need a bone marrow transplant, then a family study will be performed to identify a suitable match. A match is considered to be best when the 6 known major HLA antigens are identical.

Finding a donor is not your responsibility. Around 70% of patients do not have a fully matched donor for transplant in their family. In such scenarios, the transplant facility or hospital will have a registry of donors.

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Other Possible Donor Options for the Bone Marrow Transplant Include

• Haploidentical ( half-match) stem cells:  These are obtained from the sibling or biological parent who exactly matches half of your HLA. Biological parents are always half-HLA matches for their children whereas siblings have a 50% chance of being half-HLA matches.
• Umbilical cord blood stem cells: These stem cells are obtained from the placenta and umbilical cords after birth.

Becoming a Donor for a Bone Marrow Transplant

People who wish to donate stem cells for a BMT need to get in touch with the nearest BMT transplant center or hospital. Usually, the prospective donor is asked questions to confirm his/ her suitability for the transplant. Several tests will be conducted to determine the donor’s physical fitness. The donor’s HLA type is determined and will be used for matching with patients.

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Conclusion

If you have been advised by your hematologist to undergo an allogeneic bone marrow transplant, you need a compatible donor. Finding the right donor is not your responsibility. You should rely on your healthcare team to identify a suitable donor for you. In case, you are unable to find a donor for your allogeneic transplant, then you should discuss the other options for you.

Reference Link:

• https://www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/what-bone-marrow-transplant-stem-cell-transplant
• https://www.mskcc.org/cancer-care/diagnosis-treatment/cancer-treatments/blood-bone-marrow-stem-cell-transplants/allogeneic