The stem cell donation and transplantation for serious diseases of the blood

Stem cells are located in the bone marrow. These stem cells, also called progenitor cells, can develop and mature into the various cells of the blood. In the case of serious blood diseases, such as blood cancer, the transplantation of blood stem cells can be a promising therapy.

As a rule, healthy, adult persons can be considered as donors. Those who wish to donate can have their tissue characteristics typed by oral swabbing. The data is stored in a registry and matched with patient data.

A stem cell transplantation as a therapy for serious diseases of the blood

Hemopoietic stem cells reside in the bone marrow and continue to develop into the various blood cells. For serious blood diseases, such as blood cancer (leukemia), stem cell transplantation represents a promising therapy. In a stem cell transplant, the patient’s bone marrow and diseased stem cells are first destroyed by total body irradiation or high-dose chemotherapy.

Then healthy stem cells are taken from a donor. The stem cells will be transferred to the recipient in the next step. Ideally, these stem cells will develop into a new hematopoietic system in the recipient’s body.

BZgA / Birgitta Petershagen

Procedure of a stem cell donation

In a stem cell donation, the stem cells are obtained either directly from the bloodstream (peripheral stem cell donation) or from the bone marrow (bone marrow donation) of a donor. Stem cells can also be obtained from umbilical cord blood of newborns. Umbilical cord blood donation is still of minor importance in practice.

Peripheral stem cell donation involves drawing blood from the donor. She or he is previously given a drug (growth factor) that increases the formation of stem cells in the bone marrow so that they enter the bloodstream and accumulate there.

The stem cells are then removed from the blood in a special procedure (apheresis). For this purpose, two venous accesses are made; the blood exits from one and the stem cells are extracted; the blood flows back into the body via the other access.

Success factors of a stem cell transplantation

For a stem cell transplant to be successful, various tissue characteristics (so-called human leukocyte antigens = HLA) of donor and recipient must match. The probability of matching tissue characteristics is highest among siblings.

In many cases, however, patients are dependent on donations from outside their relatives. For this purpose international and national donor databases are maintained.

Requirements for a stem cell donation

In principle, any healthy person of legal age can donate blood stem cells. The maximum age for a blood stem cell donation is 61 years. In order to exclude a health risk for the donors and recipients as far as possible, there are various restrictions and reasons for exclusion.

Similar deferral and exclusion criteria apply as for a blood donation. People with certain diseases of the cardiovascular system or certain infectious diseases are not eligible for stem cell donation.

The Central Bone Marrow Donor Registry

In order to increase the probability of finding a suitable stem cell donor, all data from the various donor files in Germany are collected by the Central Bone Marrow Donor Registry (ZKRD). Stem cell donation is therefore the only type of donation in which possible donors are centrally recorded with their tissue characteristics.

If you would like to register as a stem cell donor, you can obtain information from the donor databases and have your tissue characteristics typed. For this a swab of the oral mucosa is usually taken.

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