November is National Marrow Donor Month. By the end of this year, 45 patients will have received a bone marrow transplant at Yale-New Haven Hospital, the only facility in the state that does this often life-saving procedure.

For most of these patients, they will receive bone marrow donated by a total stranger. While siblings are generally considered the best match for a patient, only one in four cases will have a family match, said Dr. Dennis Cooper, medical oncologist and director of the bone marrow/stem cell transplant program at Yale-New Haven. The rest are dependent on finding tissue matches from unrelated donors, many found through the National Marrow Donor Program.

"Some people never find a match . . . the more people that join [the registry], the greater the opportunity to find a match," said Pat Thompson, spokesman for the NMDP, which started in 1987. While there are 6 million donors on the registry, there is always a need for more, especially among the black, Hispanic and Asian communities, said Thompson and Cooper.

The need for more donors is why Yale-New Haven is teaming up with WFSB Channel 3 for its third annual bone marrow drive on Nov. 17. Rebecca Lobo, former UConn women's basketball star and supporter of bone marrow donor registry, is promoting the event and will be at the hospital on the day of the drive.

Donating marrow is a much less invasive, simpler procedure than most people may know, say the experts.At the Nov. 17th drive, volunteers will

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have a cheek swab to collect DNA then tissue typing will be done, said Cooper. Once a person is typed, the information goes into the donor bank. If a patient, for example in Iowa, has the same typing, that donor would be contacted.

"Once someone is identified as a potential donor for a patient, the next step is to call the donor and make sure they are still interested," said Cooper. After confirming the typing and that the donor is healthy, the next step is collecting the bone marrow.In the past, donors were required to donate actual marrow, which is still one method of collection, but donating now is as easy as donating blood.

According to Thompson, donors have a choice of three ways to donate bone marrow: marrow is extracted from the donor's hip under anesthesia; stem cells are collected from donated umbilical cord blood; or through blood donation, when peripheral blood stem cells are collected. "Traditional collection is to go to the operating room and have bone marrow harvested while under anesthesia," said Cooper. "More commonly [now], a donor will receive injections of medications usually for three to four days. They cause the bone marrow cells to start dividing."

These marrow stem cells circulate in the blood stream. The blood is collected from the donor through intravenous lines; the stem cells are harvested; and the blood is returned to the donor."Stem cells can be taken directly to the patient or frozen," said Cooper.

The patient receives the stem cells in a procedure similar to a blood transfusion that takes less than an hour, he said. Once a match is found, the patient's transplant doctor decides if marrow, PBSC or cord blood is best for the patient, according to Thompson. The use of PBSC and cord blood has been increasing over the last five years.

According to statistics from Thompson, in 2002 there were 1,179 transplants using marrow; 847 using PBSC; and 76 using cord blood. In 2005 there were 821 transplants using marrow; 1,700 using PBSC; and 325 cord transplants."Cord blood is a relatively new procedure that is becoming more popular. Mothers are becoming more aware that they can donate the umbilical cord," said Thompson.

Bone marrow transplant is the only curative therapy for patients who have recurrent leukemia or whose leukemia won't go into remission, said Cooper. But there are other diseases — such as lymphomas, multiple myeloma and other bone marrow failure disorders — that patients will benefit from a marrow stem cell transplant, he said.

Over time, donor cells become tolerant of the patient. Transplants work not only because the donor cells produce healthy blood cells, but because "the donor cells can recognize leukemia cells as foreign and destroy them, sometimes more potently than we can with radiation," said Cooper. After a year, following the transplant, and if both parties agree, a patient and donor meeting can be arranged by the NMDP. The organization helps facilitate two to three patient/donor meetings a month, Thompson said.

Yale-New Haven Hospital's bone marrow drive will take place Nov. 17 from 11 a.m. to 6 p.m. at the hospital's East Pavilion Cafeteria, 20 York St., New Haven. Rebecca Lobo is scheduled to visit YNHH the day of the drive.Donors must be between the ages of 18 and 60 and in reasonably good health.For more information, e-mail Susan Faraone at susan.faraone@ynhh.org.For more information on becoming a donor, call the New England Marrow Donor Program at 1-800-676-4545 or visit www.marrow.org.