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Is it safe to donate bone marrow if the donor has skin cancer?

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Forgive me if this question is not well suited to your site and if it is long. This is to get some help from you about a problem which irritates me from a long time. One of my colleagues at my office did a typing blood test. It was to see whether his bone marrow transplant matches his sister, who had been suffering from some sort of blood cancer. So he is the donor of marrow, but he had a medical history of some skin cancer. I am sure that it is some of a harmless type. But he unknowingly told the nurse that he had melanoma, due to his belief that every sort of skin cancer is termed melanoma. So, he wrote this term melanoma in the documents required. Is it necessary to double check which type of cancer it was? But as I know, he only had and it was treated and cured by then itself. Is it safe to transplant his marrow to his sister? Please guide me with this topic. Thanks.

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Category: Family Physician-GP
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First and foremost, it is important to know the type of skin cancer which your colleague had. Though he has been treated completely. So definitely do a double check on that. There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma. Nonmelanoma skin cancer is generally curable. The cure rate for nonmelanoma skin cancer could be 100%. So your colleague could have been treated for this condition. Your colleague will have to collect all his medical records of skin cancer treatment. Because it is important to have a record of completely treated of skin cancer before you even think about bone marrow transplant. Basal cell carcinoma is the most common form of skin cancer and accounts for more than 90% of all skin cancer in the U.S. These cancers almost never spread (metastasize) to other parts of the body or it's very rare to spread through blood stream. However, having said this, rare things sometimes rarely happen. So it is of your colleague and his sister choice to outweigh the benefit. Bone marrow transplant is a lifesaving procedure, and risk of obtaining a skin cancer if your colleague is treated completely is quite less, though a nil guarantee of not getting skin cancer cannot be given.

I would suggest consulting with bone marrow transplant physicians with the complete medical record of all illness your colleague had in the past and the treatment he had undergone. This will help them to evaluate the fitness of your colleague to be a bone marrow donor. Moreover, HLA tissue typing should also be done in which we look for donor who matches their patient's tissue type, specifically their human leukocyte antigen (HLA) tissue type. HLAs are proteins or markers — found on most cells in your body. The immune system uses these markers to recognize which cells belong in your body and which do not. The closer the match between the patient's HLA markers and your colleague’s, the better for the patient.

As much as possible, I would suggest to look for other donor without any history of cancer or other illness like hepatitis and HIV. If not able to find any at all, then her brother bone marrow can be considered. The decision should be taken by the patient and her brother after informing the risk and benefits of such a transplant by the medical team.

Hope this helps. Please feel free to ask if you need further help.

Thank you.

Dr. John Monheit
Category: Family Physician-GP
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
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