PBSC and Marrow Donation

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Two Ways to Donate

If selected as a match in the registry, donors are asked to donate via one of two procedures: Peripheral Blood Stem Cell (PBSC) donation (76% of the time), or marrow donation (24%).

PBSC and marrow donation differ in a number of ways and the decision to use either method is determined by the doctors administering the marrow transplant. Factors that impact this decision include, but are not limited to, the disease, age, and condition of the patient.

Jump to PBSC Donation
Jump to Marrow Donation

To learn more about each procedure, please read the information included below or visit the Donation FAQs at BeTheMatch.org. The majority of content on this page is taken directly from the Donation FAQs via BeTheMatch.

Note: The “Dan’s Input” sections of this page are Dan’s personal experience and perspective on each procedure and should not be considered medical advice. Please consult and follow the directions of a medical professional when making any type of medical decision.

Donating Marrow Sections

Peripheral Blood Stem Cell (PBSC) Donation

Frequency
76% of matched donors are asked to complete a PBSC donation.
Background
PBSC is a non-invasive outpatient procedure that is very similar to donating blood. Donors are given a shot of a drug called filgrastim for five consecutive days which increases the number of blood-forming cells in the bloodstream. After five days, donors are hooked to a machine which extracts blood from their arm, irradiates out the blood-forming cells via a process call apheresis, and returns the blood back to the body through their other arm.
Does it hurt?
Completing a PBSC donation is not a commonly painful procedure. The drug used to increase blood-forming cells (filgrastim) can cause mild muscle soreness, but does not commonly impact day-to-day activities.
What are the chances of something bad happening?
Less than 1% of PBSC donors experience a serious side effect from the procedure.
Dan's Input
After chemotherapy sessions I had daily injections of filgrastim (aka Neupogen) in hopes of "jump starting" my bone marrow into re-producing blood cells. Over the course of my 8 months of treatment, I'd estimate that I had 30+ Neupogen injections. My experience is that it can result in a mild achy feeling in parts of your body, almost as if you had gone on a strenuous hike the day before, but it never prohibited me from going about my day as normal.
Learn more
Donation FAQs, Steps of Donation at BeTheMatch.org, The Difference between Marrow and PBSC Donation at marrowdrives.org, PBSC Donation Process on YouTube

Diagram of peripheral blood stem cell donation process

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Marrow Donation

Frequency
24% of matched donors are asked to complete a marrow donation.
Background
Marrow donation is a surgical procedure completed under general anaesthesia (96% donors are put to sleep, whereas a small percentage of donors receive local anaesthesia). The average anaesthesia time is two hours.

During marrow donation, doctors commonly use special, hollow needles to extract liquid marrow directly from both sides of the back of the pelvic bone (the patient is lying on their stomach). The incisions are less than one fourth inch long and do not require stitches.
Does it hurt?
Because donors are asleep during the procedure, donors feel no pain while marrow is extracted. However, upon waking up soreness is expected. Donors are likely to need a day or two or longer for the lower back soreness to subside, depending on various factors like age, activity level, and general health. Painkillers are likely to be prescribed.

Marrow donation is only undertaken when specifically requested by the doctor of the patient in question. This could be for a variety of reasons, such as the age (an infant/toddler and older patients may require a direct marrow donation over PBSC) or the specific disease or condition of the patient.
What are the chances of something bad happening?
From the Be The Match website: We want to assure donor safety, but no medical procedure is risk-free. The majority of donors from the Be The Match Registry feel completely recovered within a few weeks. A small percentage (2.4%) of donors experience a serious complication due to anesthesia or damage to bone, nerve or muscle in their hip region

The risk of side effects of anesthesia during marrow donation is similar to that during other surgical procedures. Serious side effects of anesthesia are rare. Common side effects of general anesthesia include sore throat (caused by the breathing tube) or mild nausea and vomiting. Common side effects of regional anesthesia are a decrease in blood pressure and a headache after the procedure.

We take all the necessary precautions to ensure the safety and well-being of the donor. To learn more, see Donor safety and support.
Dan's Input
The prospect of marrow donation is probably the single biggest reason why people choose not to become bone marrow donors. Be The Match recognizes this and, coupled with the progression of medical research/technology, PBSC is becoming increasingly prevalent within the marrow donation process. However, when marrow donation is requested it's not requested lightly; the patient in question is high-risk, high-need. The medical staff at your donation site run through a full physical screening with you to assure your safety before the procedure (including blood work) and preliminary screenings (i.e for sleep apnea) are intended to screen out donors who are likely to have complications from anesthesia.

A friend of mine recently underwent a marrow donation at Georgetown Hospital Center and I will add his perspective, via video, shortly to the site. Until then I will say that his procedure was on a Monday, he took off work on Tuesday to rest, and was back at his office by Wednesday.

The marrow extraction process is the same process that leukemia patients undergo when receiving bone marrow biopsies, albeit in a greater volume. I was awake for all three of my biopsies (they used local anaesthesia vs. general anaesthesia) and I can confirm that soreness does indeed occur. But in my personal experience the soreness subsided in a matter of days, not weeks.
Learn more
Steps of Donation at BeTheMatch.org, The Difference between Marrow and PBSC Donation at marrowdrives.org, Bone Marrow Donation Process on YouTube

Marrow donation diagram

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