How is bone marrow donation going? It hurts?” This is a question asked by Pete Friess of Sciences et Avenir on our Facebook page. That’s our question of the week, and here’s our answer. Thank you all for your participation and loyalty.
REGISTER AS A DONOR. To become a bone marrow donor and possibly save a life, go to the Agence de la biomédecine website. You will then be contacted again for a medical interview and blood and saliva samples to determine possible patient compatibility. Conditions: Be between the ages of 18 and 50, in excellent health, and not taking regular medication (other than birth control pills).
Don’t confuse the bone marrow with the spinal cord
Specifically, bone marrow donation is mainly carried out by taking blood and does not cause much inconvenience.
“Most of us often get the wrong idea about bone marrow donation by confusing bone marrow with the spinal cord,” explains the Biomedical Agency. The spinal cord is really located in the spine: taking a sample from this place seems scary. On the other hand, bone marrow can most often be obtained from a simple blood test or otherwise from the posterior pelvic bones. “Therefore, no impact on the spine and the risk of being paralyzed after donation, as we often hear,” the agency maintains.
To understand, let’s go back to the bone marrow. It occurs throughout the skeleton, especially in flat bones such as the pelvic bones. Internally, so-called “hematopoietic” stem cells are produced, which then turn into cells necessary for life: red blood cells (which carry oxygen through the bloodstream), white blood cells (immune cells that protect the body from external attacks) and platelets (cells that circulate in the blood, responsible for coagulation). When the bone marrow functions poorly or does not function at all, it is easy to understand why the consequences are catastrophic. This applies to many patients suffering from, for example, cancer or genetic diseases such as sickle cell anemia, who are therefore in need of a transplant.
Step 1 delivery: preparation a few days before collection
In order to restore the donor’s precious cells, a drug is administered to the donor a few days before the donation. Called G-CSF, “it is used to stimulate the production of bone marrow cells and move them from the bones into the blood,” explains the Biomedical Agency. The side effects of this treatment vary in intensity depending on the person, but usually include some flu-like symptoms (body aches, headaches, etc.). Two donors shared their experiences with Science et Avenir. The first, Robin, says he felt “a little flu” symptoms, while the second, Laura, claims he “felt almost nothing but a few pains” and went on with his life “as usual.”
Donation stage 2: collection, blood in 80% of cases
Once the precious cells have been obtained in this way, it is usually enough to take a blood sample, which is called cytapheresis. In practice, the donor is connected to a blood collection machine that filters their blood to only take cells from the bone marrow and return the rest. The sample “lasts about 4 hours… followed by a well-deserved gourmet break!” the agency clarifies, adding that a second sample is sometimes needed.
However, in 20% of cases, a blood sample is not suitable, and bone marrow must be taken directly from the pelvic bone. This is an operation under simple general anesthesia. “For this sample, qualified personnel care for you in the hospital for 48 hours,” the Biomedical Agency said. Risk, excluding the risk of anesthesia? a few days.
Please note that the time of delivery is selected in agreement with the donor. “D-Day won’t come in a week,” says Laura, “I was able to choose the week that worked best for me.” Bone marrow donation, unlike organ donation, is not an emergency donation because the donor is alive and therefore the graft is not at risk of degradation prior to removal. Thus, Robin, like her, was able to organize upstream and obtain, if necessary, a stoppage of work for a few days from the Biomedical Agency.
One chance in a million patient compatibility
Please note that registrants are unlikely to be called. The doctor always looks for donors among the patient’s siblings first, because there is one in four chances that a sibling is compatible. Otherwise, the doctor will apply to the register of voluntary donors. But on average, there’s only a one in a million chance that one of us is compatible with one of these patients somewhere in the world. Hence the importance of as many as possible registered in the registry!
The Biomedical Agency encourages men in particular to register, especially if they are under 40 years old. Their bone marrow grafts (cells) are indeed better tolerated by patients and have a higher chance of success than female donors: “their bone marrow is not exposed to the antibodies that a woman could potentially develop during pregnancy.” Sciences et Avenir Dr. Evelyn Murray, Director of Hematopoietic Stem Cell Collection and Transplantation at the Biomedical Agency.