Welcome to the Caregivers for BMT, CAR-T and Hematology blog. Here you will find information relevant to you when caring for a loved one before and after cellular transplant or CAR-T therapy. It is intended to give you the education, resources and support to help you care for your patient and yourself during this time.

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Donor Information

This information is for allogeneic stem cell transplant only. Talk to your doctor about the donor process and resources.

 

Determining if you’re a match. The test to determine if the donor and the patient’s tissue-type match is called Human Leukocyte Antigen (HLA) typing.  

  • This test is performed by taking a blood sample from you.  
  • The laboratory will look at your DNA and compare it to your family member to see if you are a match.  
  • It can take several days for the physician to receive the results of this test and share them with your family member. 
  • If you are a match, you will be notified by the BMT team and asked to have a medical evaluation.  
  • Certain testing will be performed to determine if you are healthy enough to donate. 
  • Usually all expenses for the HLA typing, medical evaluation, and donation will be covered by your family member’s health insurance. If your family member’s health insurance does not cover these costs, you or your health plan will be asked to pay the cost.

Video describes crossmatch for blood and marrow donation and how a donor is identified. Describes the collection process (apheresis), risks and side effects.

The donation can be performed in two different ways: apheresis or bone marrow. The type of donation will be selected by your family member’s physician based on the patient’s disease and needs.  

 

Apheresis donation: Apheresis donation is usually performed on an outpatient basis. This means you generally won’t need to stay overnight.  

  • You will be given a series of injections of a medication called Neupogen (filgrastim) for 4 days before the donation.  
  • These injections are given in the abdomen or arm and will continue during the donation days.
  • This medication increases the number of blood-forming cells in your bloodstream. 
  • Common side effects from this medication include headache and bone or muscle aches for several days before donation. 
  • On the first day of donation, a needle attached to special tubing will be placed in each arm. Your blood is then circulated through the tubing and passed through a machine that spins and separates out the blood-forming cells. Your blood is returned to you through the other arm. If your veins are too small, you may need to have a special catheter inserted in a large vein near your neck. This catheter is placed by a doctor who specializes in this type of procedure. The catheter is temporary and will be removed after the donation is completed. 
  • Because you have healthy bone marrow, your body will replenish all of the cells that you donate relatively quickly. You should return to normal levels of blood forming cells within 4 to 6 weeks.

 

Video discusses the process of collecting stem cells (bone marrow). Marrow is primed using a growth factor to increase the production of blood stem cells. When enough cells have moved into the bloodstream, collection can begin through a process called apheresis.

 

Bone marrow donation: Bone marrow donation is a surgical procedure that takes place in a hospital operating room. 

  • You will receive general anesthesia and feel no pain during the donation.  
  • Doctors use a special needle to withdraw liquid marrow from the back of your pelvic bones.  
  • The entire procedure takes about 2 to 3 hours.  
  • You may stay overnight in the hospital after the procedure to be monitored to make sure you are feeling well and any pain you have is controlled with medication.  
  • A common side effect of the marrow donation is soreness in the lower back for a few days after the procedure.
  • Because you have healthy bone marrow, your body will recreate all of the cells that you donate. The marrow replaces itself completely within 4 to 6 weeks.
  • Additional information and videos about donating by apheresis or marrow can be found on the Be The Match website. Click on “Donate bone marrow” in the middle of the page, then “Donation process.”

Video overview of the bone marrow collection process, before, during and after the procedure.

 

Care of the collection sites: “Collection sites” refer to the places on your body where the incisions are made to collect the bone marrow. After your bone marrow has been collected, thick pressure bandages are applied over the collection sites to minimize bleeding. Keep the pressure bandages dry. 

  •  If you are still in the hospital 24 hours after the procedure, the health care team removes the pressure bandages and covers the sites with adhesive bandages.
  • If you are out of the hospital, after 24 hours, you can remove the pressure bandages and cover the sites with adhesive bandages (such as Band-Aids™).  
  • You can shower after the pressure bandages are removed as long as the sites are not bleeding. 
  • Pat the sites dry with a clean towel after showering. Then place adhesive bandages over the sites. You may remove the adhesive bandages the next day.  
  • You can take a bath after the collection sites have scabbed over. This is usually in about three days.
  • Check the collection sites every day after your shower or bath, and follow the instructions about who and when to call if you notice any of the symptoms. 
  • Reference Caring For Yourself After Bone Marrow Collection.

 

When to contact your health care provider: If you notice any of the following symptoms, immediately call a member of your health care team. If you are not sure who to call, ask before you leave the hospital or clinic.  

  • Infection. Signs of infection include:
    • Increased tenderness, redness or swelling at the site.
    • Increased pain or pain not relieved by pain medications.
    • Drainage or bad-smelling odor coming from the site.
    • Temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or greater.  
  • Bleeding from the collection sites that soaks the pressure bandages or does not stop when you apply direct pressure for 15 minutes.  
  • Headache.  
  • Pain shooting down your leg.
  • Dizziness or a light-headed feeling.
  • If you are seen by a local health care provider for something related to your bone marrow collection, call the transplant nurse care coordinator as soon as possible to let him or her know. 
  • If you have questions about your bone marrow collection, call the transplant nurse care coordinator.

Interested in becoming a donor?

Find more information on joining the National Bone Marrow Registry at Be the Match.