BACKGROUND: The National Marrow Donor Program (NMDP) receives federal funding to operate a registry of over 4 million volunteer donors for patients in need of a hematopoietic stem cell transplant. Because minority patients are less likely to find a suitably matched donor than whites, special efforts have been aimed toward recruitment of minorities. Significant financial resources are required to recruit and tissue type additional volunteer donors. METHODS: Population genetics models have been constructed to project likelihoods of finding a human leukocyte antigen (HLA)-matched donor for patients of various racial/ethnic groups. These projections have been made under a variety of strategies for expansion of the NMDP Registry. Cost-effectiveness calculations incorporated donor unavailability and other barriers to transplantation. RESULTS: At current recruitment rates, the probability of an available HLA-A,B,DRB1 matched donor is projected to increase from 27% to 34%; 45% to 54%; 75% to 79%; and 48% to 55%, for blacks, Asians/Pacific Islanders, whites and Hispanics, respectively, by the year 2007. Substantial increases in minority recruitment would have only modest impacts on these projections. These projections are heavily affected by donor availability rates, which are less than 50% for minority volunteers. CONCLUSIONS: Continued recruitment of additional volunteers can improve the likelihood of finding an HLA-matched donor, but will still leave significant numbers of patients of all racial/ethnic groups without a match. Efforts to improve donor availability (especially among minorities) and to increase the number of patients with access to the NMDP Registry may prove to be more cost-effective means of increasing transplants.
BACKGROUND: The National Marrow Donor Program (NMDP) receives federal funding to operate a registry of over 4 million volunteer donors for patients in need of a hematopoietic stem cell transplant. Because minority patients are less likely to find a suitably matched donor than whites, special efforts have been aimed toward recruitment of minorities. Significant financial resources are required to recruit and tissue type additional volunteer donors. METHODS: Population genetics models have been constructed to project likelihoods of finding a human leukocyte antigen (HLA)-matched donor for patients of various racial/ethnic groups. These projections have been made under a variety of strategies for expansion of the NMDP Registry. Cost-effectiveness calculations incorporated donor unavailability and other barriers to transplantation. RESULTS: At current recruitment rates, the probability of an available HLA-A,B,DRB1 matched donor is projected to increase from 27% to 34%; 45% to 54%; 75% to 79%; and 48% to 55%, for blacks, Asians/Pacific Islanders, whites and Hispanics, respectively, by the year 2007. Substantial increases in minority recruitment would have only modest impacts on these projections. These projections are heavily affected by donor availability rates, which are less than 50% for minority volunteers. CONCLUSIONS: Continued recruitment of additional volunteers can improve the likelihood of finding an HLA-matched donor, but will still leave significant numbers of patients of all racial/ethnic groups without a match. Efforts to improve donor availability (especially among minorities) and to increase the number of patients with access to the NMDP Registry may prove to be more cost-effective means of increasing transplants.
Authors: Karen K Ballen; John P Klein; Tanya L Pedersen; Deepika Bhatla; Reggie Duerst; Joanne Kurtzberg; Hillard M Lazarus; Charles F LeMaistre; Phillip McCarthy; Paulette Mehta; Jeanne Palmer; Michelle Setterholm; John R Wingard; Steven Joffe; Susan K Parsons; Galen E Switzer; Stephanie J Lee; J Douglas Rizzo; Navneet S Majhail Journal: Biol Blood Marrow Transplant Date: 2011-11-04 Impact factor: 5.742
Authors: Michael A Pulsipher; Neal S Young; Jakub Tolar; Antonio M Risitano; H Joachim Deeg; Paolo Anderlini; Rodrigo Calado; Seiji Kojima; Mary Eapen; Richard Harris; Phillip Scheinberg; Sharon Savage; Jaroslaw P Maciejewski; Ramon V Tiu; Nancy DiFronzo; Mary M Horowitz; Joseph H Antin Journal: Biol Blood Marrow Transplant Date: 2010-10-27 Impact factor: 5.742
Authors: B Tu; N Leahy; R Yang; N Cha; K Kariyawasam; L Hou; Y Xiao; C Masaberg; D Pulse-Earle; M Maiers; J Ng; J Kurtzberg; C K Hurley Journal: Tissue Antigens Date: 2012-11-20
Authors: Christine Rini; William H Redd; Jane Austin; Catherine E Mosher; Yeraz Markarian Meschian; Luis Isola; Eileen Scigliano; Craig H Moskowitz; Esperanza Papadopoulos; Larissa E Labay; Scott Rowley; Jack E Burkhalter; Christine Dunkel Schetter; Katherine N Duhamel Journal: J Consult Clin Psychol Date: 2011-02
Authors: Galen E Switzer; Jessica G Bruce; Larissa Myaskovsky; Andrea DiMartini; Diana Shellmer; Dennis L Confer; Linda K Abress; Roberta J King; Allyson G Harnaha; Sibylle Ohngemach; Mary Amanda Dew Journal: Blood Date: 2012-12-20 Impact factor: 22.113
Authors: Johnnie J Orozco; Aimee Kenoyer; Ethan R Balkin; Ted A Gooley; Donald K Hamlin; D Scott Wilbur; Mark D Hylarides; Sofia H L Frost; Raya Mawad; Paul O'Donnell; Brenda M Sandmaier; Ephraim J Fuchs; Leo Luznik; Damian J Green; Ajay K Gopal; Oliver W Press; John M Pagel Journal: Blood Date: 2015-11-17 Impact factor: 22.113
Authors: Loren Gragert; Mary Eapen; Eric Williams; John Freeman; Stephen Spellman; Robert Baitty; Robert Hartzman; J Douglas Rizzo; Mary Horowitz; Dennis Confer; Martin Maiers Journal: N Engl J Med Date: 2014-07-24 Impact factor: 91.245