There are two ways of donating to help patients with destroyed stem cells: one surgical (bone marrow donation) and one nonsurgical that is done with a process that is similar to donating blood (peripheral blood stem cell transplantation - PBCST).

What conditions are used to decide the method of donation?

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I'd like to preface with a brief summary of both techniques:

Bone marrow donation - The stem cells are removed from a large bone of the donor, typically the pelvis, through a large needle that reaches the center of the bone.

Peripheral blood stem cell transplantation - The stem cells may come from the blood of the patient or a donor. A peripheral blood stem cell transplant may be autologous (using a patient’s own stem cells that were collected and saved before treatment), allogeneic (using stem cells donated by someone who is not an identical twin), or syngeneic (using stem cells donated by an identical twin).

You are correct, each of these methods have been designed to replace damaged stem cells.

Damaged stem cells may be caused from:

  • Radiation
  • High doses of drugs (Recreational or cancer)
  • Diseases

Factors that may present favorable or unfavorable conditions for each of these techniques include the following:

  1. Transplantation
    Both of these methods require healthy living-donors.

Related or unrelated donors
Related against unrelated donors was in this journal article - which identifies the exact differences between these methods of stem cell transplantation.

Related - Identical siblings accelerates engraftment, but increases the risk of graft-versus-host disease when compared to Bone marrow donation.

Unrelated - No significant survival differences were found between Bone marrow donation vs Peripheral blood stem cell transplantation.

  1. Damage Tissue
    What is the tissue that has been damaged? E.g. If the patient is using immunosuppresents or if the transplantation is time-dependent (and includes wait-lists) the optimal technique may change.

  2. Other
    The patients or donor existing complications. E.g. If the patient has kidney failure, it may be advised to move away from Peripheral blood stem cell transplantation.

  3. Cost
    The treatment cost may be a valuable aspect to assess.

Often the conditions are situation dependent.

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