Monday, February 25, 2013

Bone Marrow Donation

      Obviously this is a serious topic, one that is very different from the things I have discussed in the past, but given the fact that I am currently on my pediatric hematology-oncology rotation, and that Robin Roberts was recently able to return to work, I feel that it is both appropriate and necessary to talk about bone marrow donation. I first learned about what organ donation was in third grade, because I used to love reading books by an author named Lurlene McDaniel. Lurlene McDaniel wrote books about sick children (I think her son had diabetes), and about how their illnesses affected their everyday lives. One of her books (I can't remember the name) was about a teenage girl afflicted with viral cardiomyopathy and in desperate need of a heart transplant. She joined a support group and met a friend who also needed a heart transplant. In the end, they were both very sick and they were both placed on the wait list for a heart, but only one heart became available in time. Because of this, one of the girls lived, and the other girl died waiting for a heart.
      Reading those books was how I learned about organ donation, how the process works, and how 18 people die every day, not because medical science is unable to save them, but because there are too few organs to go around. This is why bone marrow donation is so great- because no one has to die for another person to live. When I first started going out with Matt, my husband, he had just donated his bone marrow to a little boy he did not know the year before. He had signed up at the urging of his ex-girlfriend at a college drive, and was utterly astonished when they called him years later. They told him that there was a sick little boy that needed a bone marrow transplant, and that he had 48 hours to let them know whether or not he would do it. When he told me that he did not hesitate for a second, it made me like him even more, because I felt that his response was emblematic of his character in general, and the great person that he is. Believe me, not everyone would choose to say yes so quickly.
      I realized this at my medical school bone marrow drive. I just want to say this again- MEDICAL SCHOOL BONE MARROW DRIVE. I had already joined the registry years before when I first met Matt and he told me about what he did, but I tried to get my friends to sign up at school. Some of them did, of course, but to my dismay, many of them did not want to sign up to put their name in the registry even though all it took was a quick cheek swab. Why? Because they were afraid that they would eventually get called, and that they would have to say no. Why would they say no? Because they thought that the procedure to take the bone marrow would be too painful. I was appalled and I told them so. These people are supposed to be the future doctors of America. Their goal in life SHOULD be- to help people. To save people's lives. There are not many reasons to go into medicine these days unless you really care about people, so I was really surprised that they responded that way. I would understand their hesitation to donate an organ like a kidney, where they would be in life-threatening trouble if their remaining kidney failed, but not bone marrow, which replaces itself within 4-6 weeks of the donation.
      Furthermore, there are two different ways in which to donate your bone marrow.  The first, is donating your actual marrow, and the other, is donating peripheral blood stem cells. Both procedures have comparable outcomes in adults, but children experience better treatment outcomes if they receive the actual marrow. A bone marrow harvest is a minor surgical procedure usually done under general anesthesia, so the donor remembers nothing and experiences no pain except in rare cases. A needle is inserted into the back of the pelvic bone, and bone marrow is drawn out with syringes. It is a very low-risk procedure, however, most people actually choose to donate their peripheral blood stem cells. This requires one injection each day for five days of a drug called filgrastim, which increases the hematopoietic stem cells in the blood. During this process, the donor feels achy and sore due to increased proliferation of their cells. On the fifth day, the donor is connected to an apherisis machine, which draws blood from one arm, isolates the stem cells now circulating in the blood, and then transfuses the donor's blood right back into the other arm. This typically takes four to six hours. But the short time commitments necessary for either of those procedures could give a suffering patient a LIFETIME. The little boy that Matt donated his bone marrow to is not only still alive, but the treatment worked, and he is now able to live a normal life.
      There are things that you cannot take for granted in life, and health is one of those things. You never know when things can change, and no amount of money can buy you good health. In Robin Roberts case, her myelodysplastic syndrome was the result of the chemotherapy she received to treat breast cancer. Luckily, her sister was a match and was able to donate her marrow to her. It is always a relief when a family member is a match. It is the best possible scenario in a hellish situation, but family members are only a match about 30% of the time. Therefore, there are millions of people out there who do not have a familial match, and they are forced to rely on the kindness of strangers that they have never met. All I can say is to please BE THAT STRANGER. Be the person that is willing to take a few days out of your life to give someone an everlasting gift. You never know when you, or someone in your family will need such charity. 
      If you do want to enter the registry, you have to be in good health, and in between the ages of 18 and 60. There are many different registries that you can choose to join, most are international, and there are certain registries that focus on recruiting people of a particular ethnicity.  This is because certain minorities have much lower chances of finding willing and able donors, since they are not as well represented in the registry. Joining any of them is a step in the right direction in my opinion. Here is the registry that Matt and I are a part of: The Gift of Life. Only 1/540 people who join a bone marrow registry will ever get the chance to donate their bone marrow. I only hope that one day I will be given the opportunity to bestow such an incredible gift on another person in need. 


  1. Everyone should do this. For those of you who have heard stories about how painful the procedure is, its BS. The most pain I had was the feeling of a bruised tailbone.
    One of the greatest feelings in the world was when I received a card from the little boy I donated bone marrow to that said "Thank you for saving my life".

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