Ethnicity, length of time on the register and sex predict donor availability at the confirmatory typing stage

Lown, Robert; Marsh, Steven G.E.; Switzer, Galen E.; Latham, Katy; Madrigal, J. Alejandro; Shaw, Bronwen E.

doi:10.1038/bmt.2013.206

Cited by 33 publications

(50 citation statements)

References 16 publications

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“…23 These strategies bear a number of substantive tribulations including donor attrition, lengthy process and high expenses. 24 Moreover, in developing countries, infrastructures such as HLA registries and cord blood banks are sparsely distributed and underperforming specifically for pediatric patients or ethnic minorities. 25 These logistic and socioeconomic obstacles impede timely donor recruitment.…”

Section: Discussionmentioning

confidence: 99%

“…Platelet engraftment was defined as the first seven consecutive days without transfusion with platelet count of 420 000/μL. 23 Furthermore, patients were examined and classified for acute GvHD (aGvHD) and chronic GvHD (cGvHD) according to the standard criteria 24,25 and treated afterwards. Patients surpassing 100 days were evaluated for cGvHD.…”

Section: Definitionsmentioning

confidence: 99%

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Efficiency of allogeneic hematopoietic SCT from HLA fully-matched non-sibling relatives: A new prospect of exploiting extended family search

Hamidieh

Dehaghi

Paragomi

et al. 2015

Bone Marrow Transplant

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The best donors for hematopoietic SCT (HSCT) are fully-matched siblings. In patients without fully-matched siblings, HLA registries or cord blood banks are alternative strategies with some restrictions. Owing to the high rate of consanguineous marriage in our country, between 2006 and 2013, extended family searches were undertaken in Hematology-Oncology Research Center and Stem Cell Transplantation (HORCSCT), Tehran, Iran, in 523 HSCT candidates with parental consanguinity and no available HLA identical sibling. Fully-matched other-relative donors were found for 109 cases. We retrospectively studied the HSCT outcome in these patients. Median time to neutrophil engraftment was 13 days (range: 9-31days). In 83 patients, full chimerism and in 17 patients, mixed chimerism was achieved. Acute GvHD (aGvHD) grade II-IV appeared in 36 patients (33%). The frequency of aGvHD development in various familial subgroups was NS. Five patients expired before day+100. In the surviving 104 cases, chronic GvHD developed in 20 patients (19.2%). The distantly related subgroup had significantly a higher rate of cGvHD (P = 0.04). The 2-year OS and disease-free survival (DFS) were 76.7 ± 4.5% and 71.7 ± 4.7%, respectively. No significant difference in OS (P = 0.30) and DFS (P = 0.80) was unraveled between various familial relationships. Our considerable rate of fully-matched non-sibling family members and the favorable outcome support the rationale for extended family search in regions where consanguineous marriage is widely practiced.

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Section: Discussionmentioning

confidence: 99%

Section: Definitionsmentioning

confidence: 99%

Efficiency of allogeneic hematopoietic SCT from HLA fully-matched non-sibling relatives: A new prospect of exploiting extended family search

Hamidieh

Dehaghi

Paragomi

et al. 2015

Bone Marrow Transplant

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“…Here, the BBMR presents a report on donor attrition rates and causes of cancellation, with emphasis on donor‐related causes among BBMR donors at the finally selected donor (post‐VT) stage. Earlier reports from other registries identified blood donor status as a favourable factor reducing attrition (Switzer et al, ; Lown et al, ). Our hypothesis was that we might expect BBMR donors to have a low deferral rate given that they are recruited from blood donors.…”

mentioning

confidence: 94%

“…Data on the frequency of this problem are scarce, and only four international registries have published their experience. The National Marrow Donor Program (NMDP) and the Anthony Nolan Registry have reported on donor attrition at the verification typing stage (VT, previously referred to as confirmatory typing) (Switzer et al, ;Switzer et al, ; Lown et al, ). The German Red Cross Blood Service and the Europdonor Foundation in the Netherlands (providing unrelated donors for Dutch patients only) have published data on donor deferral at the point of final donor evaluation (van Walraven et al, ; Brauninger et al, ).…”

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confidence: 99%

Attrition at the final donor stage among unrelated haematopoietic stem cell donors: the British Bone Marrow Registry experience

Balassa

Griffiths

Winstone

et al. 2019

Transfusion Medicine

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SUMMARY Objectives To investigate attrition at the finally selected donor stage among British Bone Marrow Registry (BBMR) donors, all recruited from blood donors. Background The success of searches for unrelated stem cell donors relies on the existence of large international donor registries and the availability of registered donors when matched with a patient. Withdrawal of donors may adversely affect patient outcomes. Materials/Methods Data on 2942 planned donations were analysed to assess donor‐related deferral rates and associated factors. Results Overall, 20·2% of requests were cancelled. Transplant centres activated more than half of the cancellations (52·6%). Donor reasons accounted for 46·7% of cancellations (9·4% of requests), of which 61·7% happened for medical and 38·3% for personal reasons. Medical ineligibility of the donor was associated with increasing age (odds ratio [OR] = 1·36, P = 0·011) and peripheral blood stem cell source (OR = 2·22, P = 0·006), and there was some evidence of association with low blood donation reliability (OR = 1·52, P = 0·054). The blood donor reliability score relates to blood donation, and the score worsens if donors consistently fail to attend a donation session when invited. Withdrawal on personal grounds showed associations with donor age (OR = 1·72, P = 0·017, 30–40 years vs other ages), peripheral blood stem cell source (OR = 2·43, P = 0·010) and low blood donor reliability (OR = 1·94, P = 0·007). Conclusions To our knowledge, this is the first report on all‐cause cancellation at the finally‐selected donor stage for international stem cell donor provision, showing 9·4% donor‐related cancellation rate. Scores associated with blood donation reliability may be useful to predict stem cell donor withdrawal.

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“…[30][31][32] Future complete, high-resolution HLA typing and provision of additional donor characteristics could theoretically minimize the length of a search to a single day, 33,34 and probably further reduce the rate of transplant cancellations due to relapsed malignancies. This, however, may not help non-NWE patients, since the limited number of registered, available and suitable non-NWE donors in the national and international registries [35][36][37][38] highlights the need for strategic recruitment of both UD and CBU, 39 and for methods to prevent untimely opt-out of donors, in particular those from ethnic minorities. 40 Targeted donor recruitment, with personal and written native speaker support, and through social media, is being increasingly practiced.…”

Section: Discussionmentioning

confidence: 99%

The increase of the global donor inventory is of limited benefit to patients of non-Northwestern European descent

et al. 2016

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© Ferrata Storti Foundation IntroductionAllogeneic hematopoietic progenitor cell transplantation plays an important role in treatment of hematooncological diseases. For patients lacking a matched related donor, an unrelated donor (UD) or cord blood unit (CBU) may provide a valuable alternative. Alternative donors are identified through registries of volunteer unrelated donors or public cord blood banks. In the past decade, the identification and availability of UD and UCB have improved. Bone Marrow Donors Worldwide (BMDW), the file of registered unrelated donors, almost tripled (from 7.4 million donors in 2001 to over 21 million in December 2012), while the inventory of unrelated CBU grew from 87,000 in 2001 to over 500,000.1 To date (2016) the number of registered donors has increased to over 27 million, and currently over 650.000 CBU are registered. Increased knowledge of the HLA system, more well-typed donors, and the availability of several search-related software tools 2-5 have facilitated and speeded up the efficiency of the search process. [6][7][8] Simultaneously searching for a back-up donor can minimize the delay if a donor is unexpectedly not fit or unavailable to donate.9 Given these recent improvements, we set out to address the questions of whether a higher percentage of patients in need of an UD/CBU may actually reach transplantation nowadays, whether the time needed to identify an UD/CBU has decreased, and whether possible factors can be identified for potential improvement. We addressed the questions in a large cohort of 3,365 consecutive UD searches performed between 2001-2012 in the Netherlands, including searches for Dutch patients of Northwestern European (NWE) and non-Northwestern European (non-NWE) descent. Methods The patients and donor searchesEuropdonor Foundation, the Dutch Stem cell donor registry, coordinates the UD searches in the Netherlands, serving a population of 16.8 million inhabitants. There were eight adult and two pediatric stem cell transplantation units in 2012 in the Netherlands, and the number of new searches increased to approximately 500 annually. All UD and CBU searches performed from 2001 until 2012 for the patients of all Dutch transplantation centers were included (n=3,365, Figure 1) for the initial 'donor found' analysis, and divided into two periods: cohort I, 2001-2006 (n=1,093) and cohort II, 2007II, -2012. Patients for whom a search was cancelled in less time than the median search time for the given year, and for whom no donor was yet identified were excluded for the 'donor found' analysis (cohort I, n=75; cohort II, n=131), leaving 3,124 evaluable search cases. Each cohort was split according to NWE and non-NWE descent. Patients were assigned to NWE or non-NWE background based upon self-identified descent.10 Descendants from the Netherlands, Germany, Belgium, Luxembourg, Great Britain, Ireland, and Scandinavia were considered NWE. The non-NWE group consisted of patients with self-reported genetic ancestry in Northern Africa (n=51), Sub-Saharan A...

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Ethnicity, length of time on the register and sex predict donor availability at the confirmatory typing stage

Cited by 33 publications

References 16 publications

Efficiency of allogeneic hematopoietic SCT from HLA fully-matched non-sibling relatives: A new prospect of exploiting extended family search

Efficiency of allogeneic hematopoietic SCT from HLA fully-matched non-sibling relatives: A new prospect of exploiting extended family search

Attrition at the final donor stage among unrelated haematopoietic stem cell donors: the British Bone Marrow Registry experience

The increase of the global donor inventory is of limited benefit to patients of non-Northwestern European descent

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