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Tuesday, April 16, 2013
Dear Dr. Camardi:
I promised I would write and tell you how the bone marrow donation experience went. I’m all done and I’m so glad I did it!
Thanks so much for giving me all the time I took to discuss it . More than anything else, thanks for not letting me feel any pressure with whatever decision I made.
I was very, very afraid of the anesthesia, but now that it’s over, it’s probably one of the biggest and best things I’ve ever done. I’m so happy!
Everybody … EVERYBODY … should be a bone marrow donor. Thanks so, so much for being there for me.
Yearly more than 12,000 people across America are found to have a life-endangering disease for which a procedure known as a stem cell transplant can be the best or, in certain cases, the only treatment.
When you agree to be a bone marrow biopsy donor, you are giving somebody a chance for living. Doing this brings your sense of charity to a new level: You’re giving a piece of yourself to save a life.
My involvement with stem cell work goes back to the mid-’90s, when I was on a committee at my former hospital. We were evaluating different machines that harvested stem cells from the blood because we were very interested in treating sickle cell anemia by performing bone marrow transplants.
We were exploring a new science then called “cell therapies,” and were looking at simpler means of obtaining stem cells. The science was in its infancy at that time, but has come a long way.
The concept behind all of this is to collect a powerful healing force within ourselves called a stem cell. These cells have the ability to become any other cell the body needs and can even repair damage.
After suitable preparation, when given to a patient, these cells can begin to function again and support the immune systems of patients with very serious diseases, including different forms of leukemia, lymphoma, multiple myeloma and various anemias. Investigation is also under way to use biologic cell treatments for such conditions as diabetes, Parkinson’s disease, spinal cord injury, heart attack and even dementia.
The best approach is if a family member is a match for a patient, but more than 70 percent of patients don’t have a donor. That’s where you come in.
The good people who wish to become involved can take advantage of a streamlined support system called “Be The Match” (marrow.org). I encourage you to visit the website, as it has a wealth of information.
The process to join is painless and easy. When you sign up, you will get a registration kit with a cotton swab to collect cells from your cheek, which you send back.
It’s that easy. Then you wait.
Roughly one in 500 of the people tested in ages 18-44 will go on to the next step. If you’re wondering about the age range, it’s because studies have shown that those within that group have the best success rates.
The cheek cells will be labeled with identifiers and posted where doctors can pick a suitable cell type that should work for their patients.
That next step comes when you are asked to either donate some of your bone marrow or some of your blood. You can choose the method.
As a general rule, children do best with bone marrow while adults do fine with blood. You will go through a comprehensive medical examination with a lot of forms and consents to sign.
You may have to travel to another location for the procedure, but all expenses are covered.
If the bone marrow collection is the right choice, it is a surgical procedure done under general anesthesia where a needle is used to draw out some of the marrow from the back of the hip bone. You should know that less than 2 percent of those who undergo the procedure have complications.
If the blood option is chosen, a drug called filgrastim is injected for five consecutive days so as to move the stem cells out of the bone marrow and into the general circulation. During this time, you’ll feel as if you have a little touch of the flu, with some body aches.
On day five you will be attached to a machine called an apheresis device that will strain the blood for the stem cells and then return the rest of your blood to you . This takes about four hours.
Filgrastim is generally thought to be safe, but long-term studies are not in about the risks, and yes, you will be part of that study.
Once the donation is made, it is rushed — and I mean rushed — to the hospital where the patient is waiting . You don’t know who it is and they don’t know you. But both of you are forever joined by a unique bond.
But enough talk — go and make a difference.
Dr. Michael Camardi is a geriatrician at the Carilion Center for Healthy Aging and an assistant professor of medicine of the Virginia Tech Carilion School of Medicine. His column runs monthly in Extra.
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