Selection of family donors for stem cell transplant and stem cell harvest.

We are contacting you with this information booklet, as you have a sister/brother who may need to have a transplant with bloodforming stem cells from bone marrow. In this connection, you will soon be invited for a tissue type test (a blood sample) which you will probably have heard about from your sister/brother.

Voluntary

We should stress that it is optional to give a blood sample for tissue typing and to donate stem cells.

Who needs a transplant with blood forming stem cells?

The largest group of patients have leukaemia or lymphatic cancer, others have some other serious blood disease or a congenital metabolic disorder. All of the above are conditions which can be cured by a transplant with blood forming stem cells from a healthy donor.

Who are suitable donors?

There will be a greater chance of finding a donor among the patient’s full brothers or sisters. You need to have the same tissue type as your sister/
brother in order to be a suitable donor. We still do not know whether your tissue type is a match, but a blood sample can give us the answer. Furthermore, you must be healthy and able to tolerate having stem cells extracted. The patient’s
physician at the referring department will therefore ask the patient about the expected health of all siblings.

Requirements for being a donor

• Your tissue type matches your sister’s/brother's
• Your health is good (see next section).
• Your sister/brother is assessed to need a transplant.

Health-related reasons for being excluded as a donor

You generally need to be healthy in order to donate stem cells. There may be various healthrelated reasons for you to be assessed as unsuitable as a donor.

For example

• Previous or current cancer diseases
• Previous or current blood clots (cardio-vascular diseases)
• Servere pulmonary diseases
• Pregnancy

Certain autoimmune diseases (such as rheumatoid arthritis and chronic intestinal diseases), Certain autoimmune diseases (such as rheumatoid arthritis, chronic intestinal diseases, eye disorders as well as autoimmune diseases of the thyroid gland)

We enclose a ’health form’ for you to complete and return in the enclosed stamped addressed envelope as soon as possible to the Stem Cell Section at the Blood Bank.

Tissue typing

Tissue typing is determined on the basis of a blood sample. The blood sample is taken at Rigshospitalet’s Tissue Typing Laboratory or through your own GP.

• When the result of your tissue type is available, you will be informed about the result.
• If your tissue type is compatible with your sister or brother and there is a need for a transplant, you will be called again for a new tissue type test in order to check that the first tissue type is correct. You will also be tested for HIV and hepatitis (B and C) during this examination.
• If more than one sibling is a match, the transplant unit will select the donor.
• If there are no possible family donors, it is possible to look for an unrelated donor in Denmark or abroad.

Stem cell donation

If you are selected as a possible donor, you will:

• Receive an invitation to an information meeting about the harvest procedure from the transplant section at Rigshospitalet.
• Undergo a health examination at the Stem Cell Section at Rigshospitalet’s Blood Bank. During this examination, additional blood samples will be taken in order to carry out a health assessment.

The final assessment and decision about your suitability as a donor rest with the physicians who carry out the interview and the health examination.

You can donate blood forming stem cells through a cell harvest either from the bone marrow or from the peripheral blood. The body will automatically reproduce the donated stem cells.

Below is brief information about the two donation options. If you are found suitable as a donor and you give your preliminary consent, you will receive detailed information on the harvest procedure chosen by the physicians as the best for you.

Peripheral stem cell harvest

When harvesting cells from the peripheral blood, you will have daily injections in your thigh, for example, with medicine containing stem cell growth factor. Stem cell growth factor is a substance normally found in very small amounts in the blood. The injections with growth factor will be given for four to six days before and during the stem cell harvest. Stem cells are usually harvested over two days.

You will not be hospitalised during treatment with stem cell growth factor and you can often go to work as usual. On the day of harvest, you will meet at Rigshospitalet in the morning and you can go home in the afternoon.

The harvest is carried out by drawing blood from a vein in one of your arms, and leading it through a machine that separates some of the white blood cells, including stem cells. The remaining blood is then returned through a needle in
your other arm.

Bone marrow harvest

During the harvest of cells from the bone marrow, you will be under general anaesthesia, while blood forming stem cells are removed from your pelvic bone. You will be admitted to the transplant section at Rigshospitalet the day before the bone marrow harvest. The bone marrow harvest will be carried out the
following morning, and you can go home the following day.

Reimbursement of expenses

All your expenses in connection with the examination and a possible stem cell donation (including loss of earnings) will be reimbursed.

Bone marrow is semi-fluid tissue in the cavities of large bones. The bone marrow contains stem cells which produce red and white blood cells as well as
blood platelets. These blood-cell-forming stem cells are used in a bone marrow transplant. The presence of stem cells is vital, for example, because the white blood cells constitute the immune system that protects the body against infection.

Before the transplant, the patient is often treated with radiation and chemotherapy. The stem cells are then given to the patient through a blood vessel like in a normal blood transfusion.