November 15, 2006 Stem cells are unspecialized cells that are capable of self-renewal. When a stem cell divides, it can become another stem cell or a specific type of cell, like a blood cell or a muscle cell. Blood stem cells are the cells that form the three types of blood cells in the body - the red cells (which carry oxygen to the tissues), the platelets (clot-forming cells) and leukocytes (white blood cells that help fight infections). There are three sources of blood stem cells. They can be extracted from the bone marrow, pulled out from the circulating blood or taken from the umbilical cord blood after a baby is born. There are many more stem cells in the bone marrow than in circulating blood. Becoming a Blood Stem Cell Donor Research reports more than 15,000 blood stem cell transplants are done each year. The transplants are often used for patients with conditions like multiple myeloma, leukemia and lymphoma. Several years ago, the most common source of blood stem cells was bone marrow. The donor is placed under general anesthesia. Then, a large needle is placed into the hip bone to remove some of the marrow. The donor marrow is processed to remove blood and bone fragments. Bone marrow stem cell donation takes about one to two hours. Peripheral blood stem cell donation is the removal of stem cells in the circulating blood. For several days before the donation, patients are typically given injections of growth factors to increase the number of stem cells in the blood by about 100 times. During donation, an intravenous needle is placed into each arm. Blood flows out of one needle, through a tube and into a machine which extracts the stem cells. The remaining blood circulates through another tube and is placed back into the body through the IV needle in the other arm. Peripheral blood stem cell donation takes about 4 to 5 hours. The Need for Donors The National Marrow Donor Program estimates more than 35,000 Americans could potentially benefit from a marrow or blood stem cell transplant each year. However, there is still a great need for more donors. One of the roadblocks to blood stem cell therapy is the need to match donors and recipients. Like other organ transplants, the antigens found on the donors cells must be compatible with those of the recipient. Tissue typing is done to ensure the donor and recipient are a compatible match. Initially, patients tend to start their search for a donor within the family. However, despite the close genetics, only about 30 percent of patients in need find a suitable family match. The remaining 70 percent of patients rely on the generosity of unrelated people who volunteer to donate blood stem cells for those in need. The National Marrow Donor Program maintains a registry of more than 6 million potential donors. Worldwide, there are more than 10 million people registered to become donors. However, there is still a need for volunteers. The need is especially critical for people of ethnic minorities. Edwin Alyea, M.D., a Medical Oncologist with Dana-Farber Cancer Institute, says there is greater genetic diversity in some ethnic populations and proportionately fewer donors. Thus, it is important to encourage people to become listed with the registry to increase the chances of finding a match for someone in need. The National Marrow Donor Program says the groups with the greatest need for recruitment include: Native Americans, Asians, Native Hawaiians/Pacific Islanders, African-Americans, Hispanics, Latinos and those of mixed race. To sign up for the registry and become a potential donor, log onto the website of the National Marrow Donor Program at http://www.marrow.org. Prospective donors must meet health guidelines. Once accepted, the registrant receives a kit to collect a swab of cheek cells. There is a one-time processing fee of $52.00 to cover the cost of tissue typing. Alyea says potential donors need to realize they are making a serious life-long commitment. Donors are asked to remain on the registry until they reach their 61st birthday. Although there is no obligation to move forward with the donation if a match is made, a refusal to donate could jeopardize the life of the recipient. AUDIENCE INQUIRY For general information on stem cells: National Institutes of Health, http://stemcells.nih.gov For information on becoming a stem cell donor: National Marrow Donor Program, http://www.marrow.org BIBLIOGRAPHY "ABCs of Marrow of Blood Cell Donation," Minneapolis: National Marrow Donor Program, downloaded from website (http://www.marrow.org), October 17, 2006. Angelini, Paolo, M.D., and Roger Markwald, Ph.D., "Stem Cell Treatment of the Heart," Texas Heart Institute Journal, 2005, Vol. 32, No. 4, pp. 479-488. 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