What should I think about before I have an allogeneic stem cell transplant?

Healthy adults ages of 18 to 60 can donate stem cells. About 17 million people worldwide are registered to be stem cell donors. Children may be donors for themselves or a brother or sister. In some cases, people who are older than 60 can donate.

If you wish to be a stem cell donor, a blood sample is taken from you and tested for tissue type. It is then compared with the tissue types of people needing a transplant. If a match is found, another blood sample will be drawn to see if your tissue type matches well enough for the transplant.

If you are selected as a stem cell donor, you will have a complete physical exam. You will also be asked questions about your health and your family history of diseases. You will also be asked to sign a consent form to have the procedure.

If you are a stem cell donor, you will receive injections of a drug called filgrastim for several days. (It is also called G-CSF, for "granulocyte colony-stimulating factor.") Filgrastim is a drug that helps your body move more white blood cells out of your bone marrow and into your bloodstream. Blood will be removed from your arm, sent through a machine to remove the stem cells and returned to your bloodstream through your other arm.

The bone marrow collection process is a surgical procedure done under a local or general anesthetic. The procedure takes 1 to 2 hours. Bone marrow is usually removed from the back of your pelvic bone using sterile needles.

Umbilical cord blood banks have been established in some areas of the United States, Canada and many countries in Europe to supply stem cells for related and unrelated people. Using blood from these banks decreases the time it takes to search for a match, because the samples are already typed for genetic information (HLA) and blood group and treated for infection. The match does not need to be as specific as it does with bone marrow or peripheral stem cells. Umbilical cord blood transplants also cause fewer problems with graft-versus-host disease.

Not every hospital is able to perform transplants. You may have to travel to a hospital that has special equipment and specially trained doctors and nurses.