A study of the U.S. marrow and cord blood registry using population-based genetic models for 21 race and ethnic groups has found that, depending on the group, between 66-97% of patients will have a human leukocyte antigen (HLA)-matched or minimally mismatched available adult donor on the Be The Match Registry. The study, published in the New England Journal of Medicine, also reported that between 81-99% of patients will have at least one suitably HLA-matched cord blood unit (CBU) of adequate cell dose. For patients who are candidates for either bone marrow or cord blood transplants, the study revealed that the likelihood of having a suitably matched adult donor or CBU is between 91-99%.
Gragert L, et al. N Engl J Med
Press Release on Gragert L, et al.
Likelihood of a Match page on BeTheMatchClinical.org
Expert Commentary
Dennis Confer, M.D., Chief Medical Officer, NMDP/Be The Match
The research results from Gragert L, et al published in the July 24 edition of the New England Journal of Medicine have several important implications to the field of hematopoietic cell transplantation (HCT). Foremost, however, is the very good news that an overwhelming percentage of patients (based on racial and ethnic group 91-99%) who need an unrelated bone marrow or cord blood transplant will have a suitably matched, available donor or cord blood unit on the Be The Match Registry.
The study, led by our Bioinformatics scientists at the NMDP/Be The Match, through our research program CIBMTR, uses human HLA data from the Be The Match Registry. We used extensive high-resolution, 4-locus haplotype frequencies to build population-based genetic models for 21 U.S. racial and ethnic groups.
For the first time the analysis combines match rates of adult donors and cord blood units and incorporates donor availability, umbilical cord blood unit cell dose, and matching stringency according to currently accepted standards.
The study also confirms that transplant should not be delayed in order to wait for a perfect match and suggests the pursuit of multiple donors simultaneously, so there are several options if a potential donor is unavailable.
Although the percentages of finding an unrelated donor or cord blood unit are high, the study also shows that we cannot find a fully matched and available donor for every patient, and that therefore we cannot slow down in our efforts.
We continue to undertake measures to improve donor availability at donor registration and at time of matching and selection through ongoing contact, education, and support.