Because patients are most likely to find a compatible donor within their own ethnic group, a diverse Registry of potential donors is needed.

What is Marrow?
Marrow is a substance found inside bones. It resembles blood and contains blood stem cells, which produce red blood cells, white blood cells, and platelets important for carrying oxygen, fighting infection and helping to control bleeding.

Blood stem cells, the cells that transplant patients need to make healthy new marrow, usually live in bone marrow, but are also released naturally, in small numbers, into the circulating (peripheral) blood. A medication called Filgrastim will dramatically increase the release of blood stem cells into the circulating blood so that enough cells for transplant can be collected directly from the bloodstream.

Why Register to Donate Bone Marrow?
Every year, thousands of adults and children need bone marrow transplants — a procedure which may be their only chance for survival. Although some patients with leukemia or other cancers have a genetically matched family member who can donate, about 70 percent do not. These patients' lives depend on finding an unrelated individual with a compatible tissue type, often within their own ethnic group, who is willing to donate marrow for them.

As of January 2006 the National Marrow Donor Program (NMDP) has facilitated over 20,000 unrelated bone marrow transplants and the national Registry has over 6 million volunteer donors. In the Puget Sound region, our local donor center has more than 60,000 volunteer donors on the national Registry. There is a critical need for more volunteer donors. Many patients, especially people of color, cannot find a compatible donor among those on the Registry. Patients and donors must have matching tissue types, and these matches are most often found between people of the same racial and ethnic background. A large, ethnically diverse group of prospective donors will give more patients a chance for survival.

Tissue Typing Made Easier!
Those interested in joining the NMDP Registry must have their HLA tissue type determined. It used to be that a blood sample was collected from the potential donor, but now, in order to make joining the NMDP Registry even easier, Puget Sound Blood Center is introducing the "buccal swab" collection method. This method allows the donor to swab the interior of their mouth to collect enough cells to be HLA tissue typed. This collection method will be available at the beginning of August at all Puget Sound Blood Center Donor Centers and all blood drives.

Donor Eligibility
Donors joining the NMDP Registry must be between 18-60 years old and in good health, and must meet the NMDP Donor Eligibility Guidelines. For questions about donor suitability, contact the Puget Sound Blood Center at bonemarrow@psbc.org or 206-292-1897 or 1-800-DONATE1 x1897. Donors who are not suitable to join the national Registry can help patients in other ways such as making a financial contribution to tissue type other donors. See funding information below.

Steps to Donating Marrow

• If you match the tissue type of a patient seeking a donor, additional testing will confirm the results. You will meet with donor counselors at the Blood Center who will help you make an informed decision about donating your blood stem cells.
• The marrow collection process usually does not require an overnight stay in the hospital. The procedure itself is painless, because it is performed under anesthesia. But, for an average of two weeks following the procedure, most donors experience sore hips and some must restrict their activities. Even with some soreness, most donors report that donating marrow is a very positive experience and that they would be willing to donate again.
• The donated marrow is transfused to the patient, whose diseased cells have been destroyed by intensive chemotherapy. In time, the donated marrow engrafts and begins producing healthy blood cells.

Steps to Donating Peripheral Blood Stem Cells (PBSC)

• For four days before, and the day of, PBSC donation, the donor is given an injection of a medication called Filgrastim to increase the number of blood stem cells in their bloodstream.
• The peripheral blood stem cells are collected by apheresis, the same process used to collect platelets. The donor's blood is removed through a sterile needle placed in a vein in one arm, and passed through an apheresis machine that separates out the blood stem cells. The remaining blood, minus the blood stem cells, is returned to the donor through a sterile needle in the other arm.
• Unlike marrow donation, PBSC donation does not require anesthesia — the most significant risk of marrow donation. PBSC donors experience symptoms such as bone pain and muscle pain while receiving Filgrastim.

Why are More People of Color Needed?
Because patients are most likely to find a compatible donor within their own racial and ethnic background, a diverse group of potential donors is needed. Only a small percentage of the 6 million volunteer donors who have joined the national Registry are people of color. Percentage of ethnic groups on the national Registry:

• African American, 8%
• Asian/Pacific Islander, 7%
• Hispanic, 7%
• Native American, 1%
• Multi-Racial, 2%
• Caucasian, 75%

Funding
When someone volunteers to join the national Registry of potential donors, a buccal (cheek skin cell) swab sample is taken and is tissue-typed. This typing costs $52 per donor. The Puget Sound Blood Center is sometimes able to reduce this cost to $25 per donor, depending on available NMDP funding and other contributions. Because funding is limited and the need to diversify the Registry is so critical, the Federal Government pays the entire fee for people of ethnic minorities. In addition, the Puget Sound Blood Center occasionally holds sponsored donor recruitment drives, where the typing fee for Caucasian donors is covered. For more information about upcoming funded drives, please contact the Bone Marrow Donor Program at 206-292-1897. Once a donor is found to match a patient, all medical costs of the collection are covered by the patient or patient's medical insurance, as are donor expenses and other non-medical costs.

Individuals wishing to make a tax-deductible contribution to the Bone Marrow Donor Program's Donor Typing Fund should contact the Program Supervisor at (206) 292-2305 or (800) 366-2831 x2305. Your support is greatly appreciated.