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Old 08-17-2016, 01:59 PM
Vicsage Vicsage is offline
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Bone marrow transplants

It's not uncommon for parents to save their child's cord blood in case the child should ever need a transplant. Apparently it can be stored for years, maybe decades. Why don't young adults store bone marrow, when they are healthy, just in case they need when they are older? While the vast majority of the time, they will never need it, if they do, they really need it. It would be like buying hurricane insurance. Most people never use it. Is it because you can't store it for a lengthy period of time like cord blood? Is it the cost? If so, at least the rich could do it, but I've never heard of it being done. I know if the marrow was stored a year or two before the disease occurred, its probably also got the mutation, but 10 years is probably fine.
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Old 08-17-2016, 02:05 PM
Chihuahua Chihuahua is offline
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Nm

Last edited by Chihuahua; 08-17-2016 at 02:07 PM.
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Old 08-17-2016, 02:06 PM
nearwildheaven nearwildheaven is offline
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Most cord blood donations go to a bank; banking it is free to the donors, but preserving it in the event that you may need it is quite expensive and only recommended if the child is at risk of a condition that may call for a stem cell transplant.

Placental blood is chock-full of stem cells. When I worked at the hospital a few years ago, I found out that processing it cost about $1,500 and then $200 a year for cold storage.

So few people need this done that it just isn't practical, and Chihuahua is right - marrow donation is not exactly a painless procedure.

Last edited by nearwildheaven; 08-17-2016 at 02:07 PM.
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Old 08-17-2016, 02:15 PM
Vicsage Vicsage is offline
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While I figured the cost would be excessive for the average person, for the rich, its a drop in the bucket. Also I believe that they no longer require a donor to have it removed from the bone, but instead they can get the stems cells from the blood with much less pain. And I don't see it any different from any other kind of insurance that people buy and never use.
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Old 08-17-2016, 02:59 PM
Flyer Flyer is offline
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Quote:
Originally Posted by nearwildheaven View Post
Most cord blood donations go to a bank; banking it is free to the donors, but preserving it in the event that you may need it is quite expensive and only recommended if the child is at risk of a condition that may call for a stem cell transplant.

Placental blood is chock-full of stem cells. When I worked at the hospital a few years ago, I found out that processing it cost about $1,500 and then $200 a year for cold storage.

So few people need this done that it just isn't practical, and Chihuahua is right - marrow donation is not exactly a painless procedure.
Based on your figures, I disagree that it's expensive. A lot of people pay roughly $1500/year for luxuries--cable TV, storage units, and the like.
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Old 08-17-2016, 04:09 PM
USCDiver USCDiver is offline
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Originally Posted by Vicsage View Post
While I figured the cost would be excessive for the average person, for the rich, its a drop in the bucket. Also I believe that they no longer require a donor to have it removed from the bone, but instead they can get the stems cells from the blood with much less pain. And I don't see it any different from any other kind of insurance that people buy and never use.
I don't know as much about banking a bone marrow aspirate for future use, but I can tell you that stem cell aphoresis requires stimulation of the marrow to produce and then release a large number of stem cells.

I had this procedure done for treatment of myeloma about 3 years ago and the first step is a "near lethal (we hope) dose of malphalan". For about a week afterward I had essentially no functioning immune system. Way too much risk for an elective procedure.
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Old 08-17-2016, 04:22 PM
Vicsage Vicsage is offline
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The donor is suppose to be at near zero risk. The receiver of the bone marrow (you) have the big risk. First, the temporary loss of an immune system, then unless the marrow comes from the sick person after being treated or an identical twin, you have the risk of graft verses host reaction. Not knowing how you were treated, I'm going to assume you were given back your own marrow after it was treated. That's often used in myeloma. If for example you had banked healthy marrow 10 years ago, the treatment would have been easier. And if you were given someone else marrow, you probably know the risk of gvh. Banking your own eliminates this risk.
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Old 08-17-2016, 07:13 PM
USCDiver USCDiver is offline
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Originally Posted by Vicsage View Post
The donor is suppose to be at near zero risk. The receiver of the bone marrow (you) have the big risk. First, the temporary loss of an immune system, then unless the marrow comes from the sick person after being treated or an identical twin, you have the risk of graft verses host reaction. Not knowing how you were treated, I'm going to assume you were given back your own marrow after it was treated. That's often used in myeloma. If for example you had banked healthy marrow 10 years ago, the treatment would have been easier. And if you were given someone else marrow, you probably know the risk of gvh. Banking your own eliminates this risk.
Yes, the donor in a traditional bone marrow transplant is put at little risk other than the general anesthesia for harvest, however as I mentioned in my previous post I am not familiar with whether bone marrow aspirate collected in this manner can be banked or not.

I'm also less familiar with the process for collecting pleuripotent hematopoetic stem cells for allogenic transplant. Although I understand that it involves, at the very least, injections of filgrastim to stimulate stem cell production prior to apheresis.

In my case, you are correct, I had an autogenic transplant. The collection process was fairly benign, other than the 3 days I had to be in the hospital for the malphalan. This was followed by a leukocyte nadir a few days later and then 11 days of filgrastim injections. I'm not entirely clear on why I required a more aggressive stimulation process, although I can surmise it was due to my diseased marrow which was further suppressed by 3 months of chemo. I was fortunate to have been able to collect 32 million cells in one apheresis session (5 million are needed for a transplant) so I have a bunch left in cryostorage if I have a relapse.
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Old 08-17-2016, 09:36 PM
Mean Mr. Mustard Mean Mr. Mustard is offline
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There are likely other reasons, but I do know that a bone marrow aspiration is not a trivial procedure. It is very invasive, very painful, and (I would assume) fairly expensive.


mmm

Last edited by Mean Mr. Mustard; 08-17-2016 at 09:36 PM.
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Old 08-17-2016, 09:55 PM
Bullitt Bullitt is offline
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Does the donor bear that cost?

I donate platelets regularly. There is no cost to me, other than time and sometimes a little pain. I've also been in the NMDP database for many years. I was called once, maybe 25 years ago, but after a second set of screening tests I was not a good match.
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Old 08-17-2016, 10:24 PM
notsoheavyd3 notsoheavyd3 is offline
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Originally Posted by USCDiver View Post
I'm also less familiar with the process for collecting pleuripotent hematopoetic stem cells for allogenic transplant. Although I understand that it involves, at the very least, injections of filgrastim to stimulate stem cell production prior to apheresis.
My understanding is that bone marrow is multipotent (able to create any blood cell) and not pleuripotent.(Able to create any cell in the adult organism.) Embryonic stem cells are pleuripotent. (Admittedly I think there's research trying to convert them to be pleuripotent but I wouldn't count on it yet.)
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