Development and operation of a program to obtain volunteer bone marrow donors unrelated to the patient

Among these matched pairs, 1829 unrelated bone marrow transplants (UR-BMT) were performed. The initial 500 UR-BMT transplanted from January 1993 to October 1995 were analyzed as of July 1998. Engraftment was achieved in 95% of cases. Probability of the occurrence of grade III and IV acute GVHD was 18.4%. The rate of disease-free survival (DFS) of the patients who had standard-risk leukemia and did not suffer from grade III or IV acute GVHD (n = 154) was 60-71% and the rate of survival of patients with aplastic anemia was 56%. It can be stated that UR-BMT is a modality of treatment which is as effective as related BMT if the occurrence of grade III or IV acute GVHD is predicted and prevented.

Section: Jmdpmentioning

confidence: 99%

Analysis of 500 bone marrow transplants from unrelated donors (UR-BMT) facilitated by the Japan Marrow Donor Program: confirmation of UR-BMT as a standard therapy for patients with leukemia and aplastic anemia

Kodera¹,

Morishima

Kato

et al. 1999

“…Such studies found mixed results regarding the relationship between previous apheresis and willingness to donate BM, and no consistent demographic predictors of donor intentions. [6][7][8][9] Later research revealed that donor attitudes and behaviors were complex phenomena shaped both by pro-donation factors, such as altruism and social desirability, and anti-donation factors, such as distrust of the medical system and religious values. [10][11][12] Although this research yields information about the types of individuals who may donate marrow and stem cells, focusing solely on such stable psychological and personality characteristics obscures the fact that donor attitudes can also be affected by education 5 and persuasive communications.…”

Section: Introductionmentioning

confidence: 99%

Decisions to register for the National Marrow Donor Program: rational vs emotional appeals

Studts

Ruberg

McGuffin

et al. 2009

Little research has examined how the content of health communications regarding the need for BM and stem cell donation affects the intentions and attitudes of potential National Marrow Donor Program (NMDP) donors. This study used an experimental design to test the hypothesis that an emotional appeal (EA) to potential donors would lead to higher rates of NMDP registration than a rational appeal (RA). Participants were randomly assigned to receive either a RA or an EA and then asked if they would (1) register with the NMDP and (2) talk with family members about NMDP registration. A total of 85% of individuals receiving the EA agreed to register for the NMDP, whereas only 49% of the participants receiving the RA agreed to register. The EA (72%) and RA (54%) groups did not differ significantly in their reported willingness to talk with family members about NMDP registration. However, multivariate logistic regression analyses indicated that the EA group endorsed significantly greater willingness to engage in both outcomes. Results suggest that an EA was more effective in motivating participants, but other sociodemographic factors were also associated with decisions about NMDP registration. EA may provide a useful and cost-effective method for increasing NMDP registration. Bone Marrow Transplantation (2010) 45, 422-428; doi:10.1038/bmt.2009 Despite a substantial roster of volunteer donors, a significant portion of individuals seeking unrelated donors through the NMDP do not find a suitable match. Recent NMDP data indicate that 15% of all individuals seeking matches from unrelated donors were not able to find a match during a preliminary search process.3 In addition, the NMDP has reported that approximately 30% of registered donors who are identified as potential matches are not available for further evaluation at the time of the request. 4 A seemingly logical solution to these challenges would be to continue to expand membership in the NMPD so as to maximize the number of available HLA-typed donors.One of the major challenges of expanding NMDP registration involves communicating relevant information to the public. There remains relatively little awareness of the opportunity and the need to register, particularly among non-Caucasian populations. 5 In addition, there is much confusion about the process of registering for the NMDP and about what NMDP registrants may be asked to do if matched to a transplant recipient. Although greater public education about the NMDP would likely increase registry participation, little research has examined ways to communicate such information to optimize recruitment efforts.A review of the literature examining the factors associated with participation in marrow and stem cell registries revealed a small set of studies. Research on donor recruitment in the early days of the NMDP focused largely on demographic variables and apheresis as predictors of becoming a marrow donor. Such studies found mixed results regarding the relationship between previous apheresis and willingness to donate BM,...

“…Starting in 1986 BM donor registries were created in both the USA and Europe. 7,8 Since then, BM donor registries have been created world-wide, enrolling millions of volunteer donors with thousands of BM collected; [9][10][11][12][13] there are currently 46 registries located in 36 countries, counting for 6.5 million potential BM donors (last up-date June 2000). The Italian Bone Marrow Donor Registry (IBMDR) was created in 1989 and there are currently 270 000 enrolled donors with 700 BM collections already performed (last up-date October 2000).…”

mentioning

confidence: 99%

Unrelated allogeneic bone marrow donation: short- and long-term follow-up of 103 consecutive volunteer donors

Gandini

Roată

Franchini

et al. 2001

Summary:Between 1992 and 1999, 105 unrelated allogeneic bone marrow collections from 103 volunteer donors (65 males and 38 females; median age 33 years) were carried out in three northern Italian centers (Verona, Bolzano and Padova) affiliated with the Italian Bone Marrow Donor Registry (IBMDR). The average volume of BM collected was equivalent in both genders (1143.1 ml for males and 1054.2 ml for females; P = 0.1), although the average volume collected for unit of body weight and the average post-collection blood volume depletion was higher in females (respectively 17.1 ml/kg and 14.2% in females, 14.8 ml/kg and 12% in males; P = 0.01 and 0.03). There was no statistically significant difference between males and females in the total number of nucleated cells collected. We did not record any acute life-threatening event during or after the bone marrow collections. The most frequent complaint was pain at the collection site (77%) followed by the onset of fatigue (38%) and nausea and vomiting (25%); all of these were short-term problems. Hospitalization was short (average 20.2 h) and donors started their normal daily activities after an average of 5.4 days. We also monitored Hb, serum ferritin levels, WBC and platelet counts in the post-collection period (average follow-up 40.1 months). All donors signed a written informed consent for a further bone marrow collection, if needed. Our findings confirm the short-and long-term safety of allogeneic bone marrow collection in volunteer donors. Bone Marrow Transplantation (2001) 28, 369-374.