Likelihood of Finding an Unrelated Donor or Cord Blood Unit

Today patients are more likely to find an unrelated donor or cord blood unit because the NMDP Registry offers a larger number of donors with greater diversity. Through the NMDP, physicians can select from three potential hematopoietic cell options for patients in need of an unrelated donor — marrow, peripheral blood stem cells (PBSC), and umbilical cord blood. (See Hematopoietic Cell Sources Tailored to the Patient for more information.)

A patient's likelihood of finding a potential unrelated donor or cord blood unit has increased with the continuing growth and increasing diversity of the NMDP Registry. The NMDP Registry includes more than 6.8 million potential marrow or PBSC donors (Figure 1) and more than 69,000 cord blood units. (Figure 2).

Figure 1.
Growth of the NMDP Donor Registry (NMDP data)

 
 View larger version

Figure 2.
Growth of the NMDP Cord Blood Registry (NMDP data)

View larger version

Nearly all (>95%) patients are able to find at least one potential 4 of 6 HLA matched cord blood unit on the NMDP Registry, the largest in the United States, and the majority will find a potential 5 of 6 match.

Due to the less stringent HLA matching requirements of cord blood, cord blood transplants with up to two HLA antigen mismatches (i.e., a 4 of 6 match) between the cord blood unit and the recipient have shown GVHD rates and survival outcomes in pediatric and adult patients similar to those for 6 of 6 HLA-matched unrelated donor marrow transplants [1-6].

Resource for patients

Patients seeking information about their own likelihood of finding a donor or cord blood unit can use NMDP's MatchView^SM. Patients may enter their HLA type into MatchView to see the number of potential donors and cord blood units they may have on the NMDP Registry. For patients not at a transplant center, MatchView can aid in discussion of whether transplant is a treatment option. For patients already working with an NMDP transplant center, their transplant center can provide the most complete information about potential donors and cord blood units under consideration.

Note: MatchView is not an alternative to a donor search conducted by a physician. For more information, see the MatchView Physician Information.

References

1. Jacobsohn DA, Hewlett B, Ranalli M, et al. Outcomes of unrelated cord blood transplants and allogeneic-related hematopoietic stem cell transplants in children with high-risk acute lymphocytic leukemia. Bone Marrow Transplant. 2004; 34(10):901-907.
   http://www.nature.com/bmt/journal/v34/n10/abs/1704681a.html
2. Styczynski J, Cheung Y-K, Garvin J, et al. Outcomes of unrelated cord blood transplantation in pediatric recipients. Bone Marrow Transplant. 2004; 34(2):129-136.
   http://www.nature.com/bmt/journal/v34/n2/abs/1704537a.html
3. Gluckman E, Koegler G, Rocha V. Human leukocyte antigen matching in cord blood transplantation. Semin Hematol. 2005; 42(2):85-90.
   http://www.seminhematol.org/article/PIIS0037196305000089/abstract
4. Takahashi S, Ooi J, Tomonari A, et al. Comparative single-institute analysis of cord blood transplantation from unrelated donors with bone marrow or peripheral blood stem-cell transplants from related donors in adult patients with hematologic malignancies after myeloablative conditioning regimen. Blood. 2007;109(3):1322-1330.
   http://bloodjournal.hematologylibrary.org/cgi/content/abstract/109/3/1322
5. Eapen M, Rubinstein P, Zhang MJ, et al. Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison study. Lancet. 2007;369(9577):1947-1954.
   http://www.thelancet.com/journals/lancet/article/PIIS0140673607609155/abstract
6. Brunstein CG, Barker JN, Weisdorf DJ et al. Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease. Blood. 2007; 110(8):3064-3070.
   http://bloodjournal.hematologylibrary.org/cgi/content/abstract/110/8/3064