New Zealand Bone Marrow Donor Registry (NZBMDR)

Each year, many patients are diagnosed with leukaemia or other life-threatening blood disorders. Bone marrow (or stem cell) transplantation is the only possible treatment for many of these patients. The most suitable donor is a fully matched (tissue-typed) family member, but only 1 in 3 patients are lucky enough to find a family match so a search for an unrelated donor is often necessary.

The New Zealand Bone Marrow Donor Registry, which is administered and operated by the Leukaemia &  Blood Foundation, lists more than 8,000 people (6,000 are Maori and / or Pacific Island) who are willing to donate their bone marrow (or stem cells) to patients world-wide. The NZBMDR is also part of a worldwide network of volunteer registries, which contains over 14 million unrelated donors.

Some tissue types can be linked to ethnic origin - people who share the same racial background are more likely to be compatible. In New Zealand, European patients have access to more than 9 million donors. However, patients of other ethnicities are less likely to have a donor available. For this reason, there is a real need for donors with Maori or Pacific Island ancestry and for donors from minor ethnic groups in New Zealand.

For more information, visit www.bonemarrow.org.nz.

Growing the donor base

Because New Zealand has the highest proportion of Polynesian people in the world, the New Zealand Registry has made a commitment to focus on enrolling Maori and Pacific Islanders as volunteer bone marrow donors. In this way, more donors can then be made available to Maori and Polynesian patients nationally and worldwide.

Choosing to become a donor

To become a donor you need to be between the ages of 18 and 40 and in good health at the time of registration. You will be asked to donate a unit of blood (470 mls) and undergo screening tests for viruses or other infections. Your tissue type will then be entered into a national database and compared with patients needing a transplant. If you match with a patient you will be contacted for another blood sample to confirm the match and asked if you are still happy to donate.

Only 1 in 1000 donors will be asked to donate stem cells in any year and you will be retired from the registry on your 56th birthday. The NZBMDR will not normally contact you unless you are identified as a potential match for a patient, but it is important that you notify the NZBMDR of any change of address as it may be many years before you match a patient.

Deciding to donate stem cells is an important decision. It is possible to decline when contacted if you have reservations. However, once you've agreed to act as a donor it is vital to follow through with the process, because about a week before the actual donation, the patient's own bone marrow is destroyed in preparation for the transplant. These treatments can be fatal unless the patient then receives healthy bone marrow, which is given to them in a similar way to a blood transfusion.

Your details are treated confidentially and are kept by the centre you donated at. Only your tissue type, age, ethnicity and sex - linked to an identifying code - are entered onto the registry, and this code is the only identifier released to the transplant centre. If you agree to donate, only appropriate medical details will be passed to the transplant team involved. Your personal details will not be divulged to anyone outside the registry without your written consent.

Bone marrow collection

If you are selected as a donor there will be no cost involved, other than your time. Your health and wellbeing both before, and after, the donation are very important so an independent specialist with detailed knowledge of stem cell donation will assess you medically and answer any questions you may have.

In New Zealand, donation occurs in Christchurch, Wellington and Auckland only, with transport and accommodation provided for you and a support person, if required.

Bone marrow stem cells can be collected in two ways:

Bone marrow donation

Bone marrow is collected from the pelvic hipbones using a needle and syringe, under a general anaesthetic. The procedure can take up to two hours. Recovery time varies, but usually you can go home the next day and resume your normal activities after two or three days. Bone marrow re-grows rapidly to replace the donated cells.

What are the risks to me?

The risks of donating stem cells by this method are the same as the risks with any general anaesthetic. The chance of a serious complication is very low but some people experience nausea, bruising and/or local pain and discomfort for several days.

Peripheral blood stem cell (PBSC) donation

Normally, a very small number of stem cells from the bone marrow circulate in your bloodstream. To increase that number, a hormone-like substance called G-CSF is injected under the skin daily for four days prior to the procedure. The stem cells are then collected by a procedure called leukapheresis.

A needle is inserted into a vein in your arm and your blood passes into a cell seperator machine, which selectively removes the stem cells. The rest of your blood is immediately returned to your body. This procedure, performed at a hospital or blood donor centre, does not require a general anaesthetic and takes about three to four hours. After this, you may go home, but you could be asked to undergo another collection procedure if the number of cells collected was insufficient.

What are the risks to me?

G-CSF is usually well-tolerated, although during the course of the injections you may experience bone pain and some flu-like symptoms, which usually respond to paracetamol. G-CSF has been used in patients for many years - the long-term effects of short treatments in normal donors, however, is unkonwn as yet.

Interested in becoming a donor?

Contact the NZBMDR:

Telephone: 09 523 5756
Toll Free: 0800 800 256 (0800 800 BLOOD)
Fax: 09 523 5757
Email: nzbmdr@nzblood.co.nz
Website: www.bonemarrow.org.nz
Postal Address: P O Box 74336, Market Rd, Auckland