My English Rose

Bone Marrow

Bone Marrow is a spongy substance found in the centre of our bones and is where the production of stem cells occurs.

When bone marrow is functioning correctly, stem cells go on to mature and form the 3 types of blood cells:

• Red Blood Cells - responsible for carrying oxygen around the body
• White Blood Cells - responsible for fighting infection
• Platelets - responsible for clotting the blood and preventing excessive bleeding

In certain types of diseases such as blood cancers like leukaemia, the stem cells do not mature properly and cannot function as intended. When they spill over into the blood stream, they start to crowd out the healthy cells, gradually reducing their effectiveness.

Chemotherapy

Intensive and very toxic forms of treatment, usually based around chemotherapy are required to halt this process. Chemotherapy drugs destroy cancerous cells but unfortunately also attack healthy cells. This gives rise to the unpleasant side effects associated with chemotherapy, including sickness, infection risk, the need for blood and platelet transfusions, loss of appetite, hair loss.

It is common to have 4 or 5 cycles of chemotherapy in order to try and:

• Get the cancer into remission
• Attempt to ensure it does not return

In Lisa's case, her leukaemia was put into remission but relapsed only 2 months after the last course of treatment finished. The treatment therefore failed and at that point her consultant advised that chemotherapy alone would not have offered a long term cure.

Bone Marrow Transplant

This process commences with high dose chemotherapy and possibly radiotherapy, that will completely destroy the existing bone marrow and stem cells.

Then, bone marrow (or stem cells) from a healthy donor are introduced into the body with the aim that production of cancer-free healthy blood, starts shortly afterwards. There are 2 types of bone marrow transplant:

Autologous Transplant

This is where stem cells are collected (or harvested) from the patient themselves, at a point when their bone marrow is healthy. This stem cell harvest is sometimes performed on patients in remission as a 'back up' in case of future relapse. This was the plan with Lisa but unfortunately the leukaemia returned before this could be done.

Allogenic Transplant

In this procedure, healthy bone marrow or stem cells are donated by another person.

In around 30% of cases, patients find a donor who is a matched sibling. The remaining 70% of patients need to find a 'matched unrelated donor'. This is someone who has volunteered to join one of the bone marrow donor registers.

There are no guarantees that a suitable donor can be found from the register. In fact, only 1 in 4 patients are successfully matched with an unrelated donor. This means that lives are lost that potentially could be saved if more donors existed and is why more bone marrow donors are required.

Please, do something very special and give people like Lisa the chance of life.

Without the chance of a life saving bone marrow transplant, the future for patients like Lisa is a bleak one.

Sadly, for 3 out of 4 people, the search for a suitably matched unrelated donor will end in failure.

That is why more bone marrow donors are required.

The steps involved in becoming a bone marrow donor are few and simple. If you are aged between 18 and 44 years old and in good general health, this is how you can do it (in the UK):

• Attend a blood donor session and inform the staff that you wish to join the British Bone Marrow Registry (BBMR)*
• An extra sample of blood will be taken to enable your tissue type to be identified
• A letter will be sent to you to confirm that your details and tissue type have been added to the register

* An alternative bone marrow donor register is maintained by The Anthony Nolan Trust.

Once you have joined the register you could be identified as a potential donor for a patient at any time. This is what happens next:

• A further blood sample is taken to enable specific tissue typing
• If you are found to be the best match for a patient you will be given a thorough explanation of the donation process
• You will undergo a medical examination to check that you are fit enough to donate, including further blood tests

The commonest method of donation actually involves the removal of stem cells from your prehipheral blood stream, rather than the bone marrow itself. This is what happens:

• For the 4 days preceeding the donation, you will be given a growth factor injection to stimulate the production of stem cells in your body
• On the 5th day and assuming that you have enough circulating stem cells, you will be connected to an Apheresis machine at hospital
• Blood will be collected from a vein in one arm, stem cells will be 'filtered out' by the apheresis machine, and the blood will be returned to your other arm

Platelet donors will be very familiar with the above process which lasts around 4 hours. No in-patient stays are required and neither is there any general or spinal anaesthetic.

You may experience some flu like symptoms for a short time afterwards but these quickly disperse and normal activities can be resumed in 24 hours.

This page is only intended as a brief summary of the bone marrow donor process. To access more detail, please visit the links page.

Compared to the fight against cancer, being a bone marrow donor is a straightforward process.

If you do decide to become a donor, either because you knew Lisa personally or you have visited this site please "let Simon Wilson know "<simail at f2s dot com>.

By offering to be a donor, you are giving people like Lisa the ultimate gift
- the chance of life.