Why Bone Marrow Donation?

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Why Marrow Donation?
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Personal Testimony: not meant for the worldly minded.

Bone Marrow Donation is actually a misnomer.  The doctors are not after your marrow per se, but are really after the stem cells in your marrow.  After killing off all the patients bone marrow, your marrow is injected into their veins and the stem cells migrate into the long bones of the body.  The donor's immune system becomes their immune system; the donors blood type and genetic material becomes their blood type and genetic material.

Typically this is done as the last resort, and only after other conventional therapies have failed.  Bone marrow donation only succeeds in about 40% of the cases, but those 40% who are saved would have otherwise died.  The donor is exchanging a couple weeks of discomfort for the opportunity to save a life.  And how often do we get the chance to do that?

Bone marrow donation does some odd and curious things. First, the patient exchanges their immune system for yours.  If you are allergic to cats, chances are the patient will be after the donation.  The reverse is also true.  The donor also gets your blood type and genetic material; if a woman receives donated marrow from a man, her blood from then on will test out genetically as that of a male.  Furthermore, if the patient and the donor are different blood types, then the patient's blood type will change and match the donor's blood type from then on. 

What about these stem cells in the marrow?  What connection do they have with fetal stem cells?  At first glance it might seem they have little to do with it, but Dr. Taylor described to me a couple stories of recipients of donated marrow who had other chronic conditions reverse themselves after marrow donation.  These included a patient with a heart condition which spontaneously healed itself after receiving donated stem cells.  It appears the donated stem cells may migrate to areas of the body where they are needed, not just to the long bones of the body.

With bone marrow, they are looking for people who are genetically similar.  That is why they look to relatives first.  But if no relatives are available, they search the registry looking for people with a certain set of genetic markers.  If they find a few people, they request additional testing.  This means they draw more blood and perform the more expensive and more thorough testing. 

Even though the national database is searched for matches over 300 times per day, the chances of a match are slim.  Their is only a one in a thousand chance of any particular donor being chosen.  Most people will stay in the database their entire lives and never be called. 

One problem is that certain genetic markers are peculiar to certain ethnic groups.  It is unfortunate, but certain ethnic groups rarely register, particularly American Indians and Asians.  If someone from those ethnic groupings requires a bone marrow donation, the likelihood of their finding a match in the database is low.  This is the advantage of the DoD Bone Marrow program.  The military has an ethnically diverse population, more so than the rest of the population.  When members of the DoD register, they enhance the numbers of people from particular ethnic groupings in the database, which saves lives.

But the DoD doesn't do this for purely humanitarian reasons.  Let's say a nuclear event occurred.  There would be an immediate need for bone marrow donors to save the lives of irradiated military members.  The DoD Bone Marrow program provides the registry which would find donors for as many people as possible.  this contingency aspect of the program is the reason Congress funds the program.  The humanitarian aspect of it is simply an added bonus.

Journal
Costs
Recreation
Why Marrow Donation?
Update

Personal Testimony: not meant for the worldly minded.