Marrow Donors Answer Critical Health Need
By Douglas J. Gillert
American Forces Press Service
WASHINGTON, Jul. 28, 1999 Senior Master Sgt. David Huppert forgot he'd volunteered to donate bone marrow. Then Christine Roberts called from the DoD Marrow Donor Program in Kensington, Md., telling him his marrow matched a man desperately in need.
By volunteering to donate marrow, Huppert joined more than 180,000 volunteers from DoD who are counted among the 3 million volunteers in the National Bone Marrow Donor Program. To date, 750 volunteers who signed up for the DoD program have provided marrow for transplants.
Even with the large number of volunteers already on file, the government can match no more than 80 percent of requests, Hartzman said. "If 80 percent do match, 20 percent don't," he said. "It will take a large number of additional volunteers to be able to fill in that 20 percent.
In late 1998, the DoD Marrow Donor Program expanded its search for volunteer donors to bases overseas. The program previously wouldn't accept overseas volunteers because donor testing was prohibitively difficult and expensive. Now, however, the center can determine marrow types using a DNA test developed by the military. The test makes it easy to hold a donor drive virtually anywhere in the world, said Navy Dr. (Capt.) Robert Hartzman, program director.
DoD has already conducted volunteer drives at bases in Asia and Europe. These complement ongoing drives for donors in the United States and aboard naval vessels.
Marrow transplantation provides the only known cure for many diseases. Approximately 75 percent of transplants arranged by the national donor program are for patients diagnosed with some form of leukemia.
The Defense Department has long led the nation in developing effective bone marrow donor programs. The Navy first initiated the military program in 1986, which was extended DoD-wide in 1990. At the same time DoD was gearing up, the Naval Medical Research Center developed the basis and technology for large- scale DNA typing. The same technology is now being used to DNA type every service member, Hartzman said.
"There is a military contingency part of the [bone marrow donor] program," he said. "Certain agents -- particularly the mustard gas types of chemical warfare agents -- and radiation can destroy bone marrow. So DoD needs to be able to respond to casualties who have had their marrow damaged."
Potential donors must sign a consent form and provide a blood sample. Both the form and the blood are sent to the donor center, where they are typed to determine their Human Leukocyte Antigen, or HLA. The HLA is critical to the bone marrow adapting to the receiver's body, Hartzman said.
"It's a completely different set of genes from what we normally think of for blood," he said. "Normally, we think of A, B, O and Rh types, which are different genes and really are less important for marrow transplants. In fact, you could convert somebody's red blood cell type with a transplant."
For donors, the transplant procedure follows a series of steps, Hartzman said. When they register, they're signing up only to be HLA-typed, listed in the national registry and contacted if needed.
Patients needing a marrow transplant have their HLA information sent to the National Marrow Donor Program in Minneapolis, where the registry is searched for potential matches. If a match is found from among DoD volunteers, Minneapolis contacts the DoD program in Maryland.
"We would call that person, ask if they wanted to continue, and, if they want to go ahead, they and their commander sign consent forms so that the commanding officer is informed there's a possibility this person will go forward to donate marrow," Hartzman said.
A physical examination, including lab tests and chest X-ray, follows and, if everything checks out, the volunteer is cleared to donate marrow. The call could come in a few days, a few months or not at all.
"Our first responsibility is to the health of the donor," Hartzman said. "We don't want to put the donor at risk."
The donation process lasts between 45 and 90 minutes. Donors are given either general or regional anesthesia. Then, four to eight tiny incisions are made in the pelvic area. The incisions are so small that no stitches are required after the marrow is harvested. After the procedure, donors usually feel some soreness in the lower back that disappears within a few days. Because marrow continuously regenerates, the donor's system completely replaces the donated marrow within several weeks.
For more information about the DoD Marrow Donor Program, call toll-free (800) 627-7693 or visit the National Marrow Donor Program Web site at www.marrow.org. The site contains information about the DoD program and upcoming recruitment drives.
Learn about Huppert's experience as a donor in "One in a Million: Reservist's Donation Gives Stranger a Second Chance at Life," in the June 1998 Citizen Airman magazine, on line (www.afrc.af.mil/HQ/citamn/Jun98/donation.htm [link no longer available]).