The U.S. National Marrow Donor Program.

Abstract

Purpose: The National Marrow Donor Program (NMDP) of the United States has nearly 650,000 unrelated potential marrow donors in its registry and > 1,225 marrow transplants have been performed.

Patient and methods: In 1991, 43% of patients who requested a search found at least one HLA-A-, -B-, -DR-identical donor in the files. The chance of finding a donor match is much better within one's own ethnic group. The individuals enrolled in the donor file are 67.0% white, 3.8% black, 3.0% Asian, 3.9% Hispanic, and 0.8% Native American. Therefore, patients who belong to ethnic minorities are at an obvious disadvantage in obtaining marrow donors. Because of this deficiency, the program has embarked on an aggressive campaign of recruitment of minority donors.

Results: Reciprocal search agreements with other countries have made another 200,000 potential donors available, but it is not likely that black patients will find help by this route.

Conclusions: Several efforts are being made to speed up the search process and to ensure more accurate definition of identities. These efforts include prospective HLA-DR typing of donors in the file, storage of a sample of frozen blood from each donor to permit class II typing (HLA-DR, -DQ) by DNA techniques, and eliminating the mixed lymphocyte culture test as a requirement for designating a given donor as HLA identical.