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The page below is a sample from the LabCE course Hematopoietic Stem Cell Transplantation. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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A volunteer donor collects DNA from a buccal swab

Finding Donors for Transplant Patients

Aulogous donors
Autologous bone marrow or mobilized peripheral blood stem cells are used for many patients with hematopoietic malignancies such as Hodgkin lymphoma and multiple myeloma. Patients undergo myeloablative therapy and then are transfused with the HSCs collected prior to therapy. The most common complications are associated with the toxic effects of myeloablative therapy and include infection and liver and lung disease.
Allogeneic donors
There are three types of allogeneic donors: related, unrelated, and umbilical cord blood.
Transplants from related donors are usually the first choice if HLA identical or haploidentical siblings or family members are available. Haploidentical transplants have a higher incidence of GVHD but are more widely available. Closely matched haploidentical transplants have approximately the same rate of success as HLA identical sibling transplants.
Umbilical cord blood transplants began in pediatric patients in 1988. According to the Bone Marrow World Wide database (BMWD), there are over 500,000 cord blood transplants available. Advantages of these transplants include the higher incidence of ethnically diverse HLA types, decreased GVHD, and lower risk of infection with CMV and EBV. The primary disadvantage is a lower rate of engraftment. In some cases, patients may receive multiple cord blood transplants to improve engraftment.
Transplants from unrelated donors are sought when the patient does not have a HLA-matched family member or their haploidentical match has several HLA mismatches. Outcomes for unrelated HLA matched donors are virtually identical to HLA-matched sibling donors, and have improved over time due to better supportive care.
The Be The Match registry which is sponsored by the National Marrow Donor Program (NMDP) has the world's largest registry of potential donors and cord blood units. Through partnerships with international registries, the registry has access to over 27 million potential donors, and more than 680,000 cord blood units.
The National Marrow Donor Program (NMDP) is based in Minneapolis, Minnesota. Be The Match (www.bethematch.org) is a nonprofit organization created by the NMDP to help patients find a life-saving transplant. The NMDP is the leader in unrelated marrow transplantation and has facilitated more than 74,000 transplants to date. Approximately 6,400 transplants are arranged through their services every year. The NMDP also provides funding for the development of new cellular therapies and research to improve post-transplant treatment and survival. Be The Match works with both international and national registries to find HLA matched donors. According to the Bone Marrow Donors website (www.bmdw.org) there are more than 27 million potential donors and 700,000 cord blood units available through these registries. Only about 30% of patients requiring an allogeneic transplant will find a match in their family. The probability of a patient finding a match in the registry ranges from 66-97% based on their ethnicity. Ethnic minorities are under-represented in the registry and the Be the Match program has established donor recruitment efforts to increase minority donors. Be the Match also provides donor, patient and professional education materials to answer questions and encourage participation in the program.
Be The Match works with various organizations conducting hundreds of registry drives every year on college campuses and other locations. Individuals may also register online at the Be the Match website. After registering online the NMDP will mail the potential donor a kit for collection of DNA samples for HLA typing.