8-21-11

What is it like to be a donor for a bone marrow/stem cell tansplant?  Since I learned that I am going to play that role, I have been trying to find out and many friends have wanted to know what is involved.  There is some information available on the internet, but much of it is not very helpful.  As with most things, it seems that the best way to learn is to actually experience the process – as I am going to do over the next ten days.  This journal is intended to describe my experience and provide what I hope is helpful information to anyone else who may consider acting as a stem cell donor.

I am donating stem cells because my brother has been diagnosed with a rare and very serious disease of the bone marrow known as myelofibrosis.  I am not a doctor and am not writing for a medical audience, so there will be no attempt to give a detailed explanation of the condition.  However, a summary, based on my limited understanding, will help explain why a transplant is necessary.

Myleofibrosis occurs when an abnormal stem cell causes bone marrow tissue to be replaced with fibrous tissues like those used in the body’s connective tissues. This is a life-threatening condition because it is in the bone marrow that most of a person’s blood cells are formed.  Blood cells are responsible for the constant maintenance and protection of every other cell in the body.  To perform that function, literally billions of new blood cells must be produced each day.  That is not possible when the normal bone marrow tissue has been crowded out by the fibrous tissue.

Until a few weeks ago, I thought of a bone marrrow transplant as a doctor drilling into the hip of a donor, removing bone marrow, and then placing those cells into the recirpient after the recipient’s existing bone marrow had been destroyed.  Actually, though, not all of the bone marrow cells are helpful in this process.  What really needs to be transplanted is a tiny fraction of the cells in the donor’s bone marrow – cells that are known as hematopoietic stem cells.  Speaking simplistically, the prefix “hemato-” means “blood” and the suffix “-poietic” means “producing.”  Hematopoietic stem cells (which we will refer to as “HSCs”), then, are the cells which produce the myriad types of blood cells which are needed to sustain human life.

Most HSCs are found in the marrow, but a few circulate in the blood stream.  In the marrow about 1 in every 10,000 cells is a stem cell.  In the blood stream, it is only about 1 of every 100,000 cells.  The stem cells found in the blood stream are called peripheral blood stem cells (“PBSCs”).  Although stem cells are hard to find in the blood stream, it seem that those cells are often better for transplanting.  So, I am going to be the donor for a PBSC transplant.

The procedure is going to be done at the M D Anderson Cancer Center in Houston, Texas.  Earlier today I flew from my home in Colorado to Austin, Texas where my brother lives.  Very early tomorrow morning we are going to drive to Houston and begin.