I never answer calls from unknown numbers. But for some reason, last October, I did. The person on the other line reminded me of a moment over a decade ago when I had submitted a cheek swab to Be the Match Foundation (now known as the National Marrow Donor Program, or NMDP) and signed up to be on the list as a potential donor for cancer patients. Ten years later, being a match wasn t just an abstract idea—I was a match.
NMDP is a nonprofit organization that finds stem cell and marrow matches for patients with certain blood diseases and types of cancers, like lymphoma and leukemia, for life-saving treatment. While more than 75% of patients find a match through the registry, there are many hurdles they must go through to find a donor. Health, age, and ethnicity are major factors that come into play, and once all that checks out, donors then have to go through with the donation process—and over half of them back out when called upon.
Over the phone, the donor workup specialist I was paired with walked me through what the treatment would most likely look like for peripheral blood stem cell (PBSC) donation, when it would happen (a few months from then), what prep would look like (several blood tests and 10 shots in the days leading up to donation to boost my production of blood-forming cells), and answered my dozens of questions.
I felt excited, but more than anything I felt honored. All I knew about the patient I’d be donating was their age, gender, and the type of blood cancer they have. Donating doesn’t guarantee recovery, but I understood what “we found your match” could mean to a patient—it meant hope.
When it comes to telling the patient those beautiful four little words, timing is tricky: Half of potential donors drop out of the process once they are alerted. But it should be noted that 90% of the time donors just have to give peripheral blood stem cells through a process that looks similar to dialysis, and only 10% of the time it is for bone marrow extraction, which does require surgery.
Ryan McLean, a New York City fireman who donated bone marrow to a three-year-old child in 2022, says the process was quick and easy, not painful and with a long recovery period as donors are often led to believe. Leading up to surgery, he recounts that he got a few physicals and tests, but didn’t have to get any injections (as I did) before surgery. After his procedure was done, he says he just felt sore for a couple of days, “but it really wasn’t terrible.”
Bone marrow transplants are typically reserved for pediatric patients, whereas PBSC are used for adults. Dr. Heather Stefanski, MD, Ph.D, Vice President of Clinical Services at NMDP, explains that this is because there are less potential side effects in the long run with bone marrow transplants, and they “don t want the younger patients, who are potentially going to be living for [another] 80 years, to have some of the complications we get with PBSC.”
All I knew about my match is that they were an adult. Even this vague detail made the hypothetical real: I could really save a life. I couldn t back out now, and the pain didn’t matter in that case.
Cayden Addison, a seven-year-old Black boy battling a rare form Philadelphia chromosome acute lymphocytic leukemia (ALL), has had two donors back out on him. His mother, Courtney Addison, tells Vogue he’s been on different types of treatments for four years, from chemo and immunotherapy to CAR-T therapy, and that finding a match for her son is critical now. “It’s really a waiting game,” she tells me over Zoom. “Either we find a donor or science catches up and we find a new treatment that gets approved.”
Finding a match often is harder for people of color than for those who are white. According to NMDP data, the odds of finding a match are 79% for white people, 60% for Native Americans, 48% for Hispanic or Latino people, 47% for Asians and Pacific Islanders, and 29% for Black people. This is because HLA markers are inherited, so patients are likely to share the same ethnic background as their potential donors. What’s more, roughly 70% of patients won’t have a match in their families. In other words, the likelihood of finding a match of your same genetic ethnic makeup is dependent on how many people from your same ethnicity have signed up on the registry.
After speaking extensively with my NMDP donor workup specialist, I went in for testing to confirm I was a healthy candidate (check)—but that the organization had found someone else who was a slightly better match for this patient. They asked if I’d commit to being the back-up donor, and a I was admittedly shocked when they called me a few weeks later to say the primary donor had backed out and if I was still committed to donating. Of course, the answer was yes.
This past February, after a few more blood tests to ensure I was still a healthy candidate, I began with my prep shots. For five days leading up to donation day, I was injected with filgrastim to boost the amount of blood-forming cells in my bloodstream. I didn’t feel side effects for the first two days, but began to feel tired and slightly out of breath by the third. These are normal side effects, and again are a small price to pay for the opportunity to possibly save someone’s life.
The day before donation, NMDP put me up in a hotel near the New York Blood Center (the location where I donated). I was instructed to get plenty of sleep and to eat a big breakfast before donation. Once at the Blood Center, I was escorted to a spacious donation room where two other donors were already hooked up to their blood machines.
I’m not very good with needles, so when the nurses came to hook me up I asked them to cover my arms with paper towels so I couldn’t see the two tubes. The one in my right arm extracted my blood and passed it through a machine that separates the PBSC from the rest of my blood, which is subsequently returned via a tube going into my left arm.
How long you spend hooked up depends on how many stem cells your recipient needs and how much they weigh. Typically, donors spend anywhere between four to six hours, but because my patient is twice my weight and I have particularly small veins, I was there for nine. Thankfully, the nurses were very attentive, my hospital bed had a television monitor with great programing, they gave away free snacks, and since I wasn’t able to move my arms a lot, I was lucky to have my partner feeding me said snacks as if I were a baby bird.
By the end of the day I was tired and excited to go to sleep early. I was happy donation day was behind me and excited to know that my patient would be receiving their stem cell therapy the very next day. My recovery over the next week was fine, the only thing that bothered me was that I was slightly out of breath for a few days as the effects of the filgrastim shots wore off. Most people who donate stem cells snap back almost immediately, and this felt like a very minimal price to pay.
On the one year anniversary of their treatment day, we’ll both be able to submit requests to meet one another. NMDP will then connect us if we both express the desire to meet. Personally, I’d love to meet them, but I also completely understand if they don’t feel the same. Cancer treatments and the often years it takes to complete them are exhausting, and it’s more than understandable to want to leave those days in the past and move forward.
On that initial phone call in October, my workup specialist asked me why I decided to register over 10 years ago. What I knew back then while filling out the paperwork in a booth stationed outside my university, is the same thing that I know now: It’s the right thing to do.