How to become a bone marrow donor?

The Leukemia Foundation is holding a Red September campaign. Yes, September is already over, but the promotion will last until mid-October, and, of course, you can always help. You can help the fund with money, but there are other ways. For example, become a bone marrow donor.

Bone marrow is not brain at all. It has nothing to do with the brain and spinal cord. It has no nerve cells. Bone marrow consists of stem cells that can turn into any other blood cells, as well as maturing, young blood cells. This is the main hematopoietic organ. It is in the bones. Through the vessels that run through the bones, new blood cells created by the bone marrow enter the circulatory system. Many people have seen bone marrow - in soup, inside the “marrow bone”. This is what bone marrow looks like after heat treatment. But living bone marrow is not a gray-yellowish jelly, but a dark red viscous liquid.

Some blood diseases (including blood cancer - leukemia) can be cured by completely renewing the patient's hematopoietic system. To do this, the patient’s own bone marrow is destroyed with chemicals, and bone marrow from a donor is “transplanted” in its place. In fact, this is not a surgical operation - the donor stem cells are simply transfused into a vein, like blood. And then the cells themselves find their way through the vessels into the bone. For a successful transplant, the donor's DNA must match the recipient's DNA in those areas that are responsible for rejection - the so-called histocompatibility genes. These stretches are long and extremely variable - making it very difficult to find a suitable donor. On average, to find a donor for a particular patient, you need to examine thousands of people.

With a 25% probability, his brothers and sisters may be completely compatible donors for the patient - when they are looking for a donor, they are examined first. Parents for children and children for parents are only half genetically suitable. From such donors (they are called haploidentical), transplantation can also be done, but it is associated with special difficulties. Another completely or almost completely suitable donor can be found among complete strangers in bone marrow donor registries. These are huge databases that store information about the histocompatibility genes of millions of volunteers.

To do this, you need to donate blood for HLA typing . This can be done for free in many clinics, as well as at special events to attract donors. The result of typing is a phenotype: a genetic formula that is entered into the register. Each potential donor is encoded in the register with a special code: his name cannot be disclosed. There are dozens of registers in the world, many of them are united into a single network. The international registry stores tens of millions of phenotypes. In the Russian register - 90 thousand. A physician looking for a donor for a particular patient and who has an account with the registry goes to the registry website and looks to see if there is a suitable phenotype in the registry. If a phenotype is found, a registry employee (in no case the patient's treating physician) calls the potential donor and asks if he is willing to donate some of his stem cells.

The donor must come to a special clinic and undergo examination . If there are no contraindications, he will be offered a choice of two ways to donate cells. Bone marrow may be removed with a needle from the pelvic bones. This manipulation takes place in the operating room, lasts about 1.5 hours, and is performed under general anesthesia.

It is also possible to use special drugs to force the donor's stem cells to leave the donor's bones into the peripheral circulatory system and, without any anesthesia, to take them out of the vein with a needle. Blood from the vein enters a special machine that extracts stem cells, and returns the rest of the blood back to the donor’s circulatory system. This procedure lasts on average four hours.

Yes. But within a couple of days after the procedure, the donor feels slightly unwell, like a cold. Since blood is also taken along with the bone marrow, donors who have material taken directly from the pelvic bones may have a slight decrease in hemoglobin. After two weeks, the donor's bone marrow is completely restored.

Valery Panyushkin