Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Donor Selection

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

Abstract

Despite over 20 million unrelated donors being listed worldwide, donor attrition at the confirmatory typing (CT) stage of donor acquisition is a key source of delay. Anthony Nolan undertook a study of CT requests from 2010 to 2011 to identify factors associated with attrition. Of 7541 CT requests, 38.2% were cancelled for donor reasons. Of these, 19.4% were personal, 34.1% medical, 36% no contact, 7.9% emigrated and 2.6% others. African (odds ratio (OR) 2.78, P<0.001), African-Caribbean (OR 3.07, P<0.001), Asian (OR 2.65, P<0.001), Jewish (OR 1.54, P=0.009) and Mediterranean (OR=2.38, P<0.001) donors were more likely not to be available compared to Caucasian donors. Female donors were also more likely not to be available (OR=1.32, P<0.001): primarily due to pregnancy. Older donors were less likely to be available in univariate analysis, but this association was not significant after controlling for other factors. Blood donors and those recruited within the past five years had lower rates of attrition. Accumulation of additional attrition-associated characteristics for a given donor was associated with progressively greater odds of attrition (OR 1.99, 2.52, 3.4 and 5.53, respectively, for 1, 2, 3 and 4 risk factors, P<0.001). Donor registries must develop evidence-driven strategies to recruit and retain the most reliable donors.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Cleaver SA . The Anthony Nolan Research Centre. Bone Marrow Transplant 1993; 11 (Suppl 1): 38–40.

    PubMed  Google Scholar 

  2. Passweg JR, Baldomero H, Gratwohl A, Bregni M, Cesaro S, Dreger P et al. The EBMT activity survey: 1990-2010. Bone Marrow Transplant 2012; 47: 906–923.

    Article  CAS  Google Scholar 

  3. Switzer GE, Bruce JG, Myaskovsky L, Dimartini A, Shellmer D, Confer DL et al. Race and ethnicity in decisions about unrelated hematopoietic stem cell donation. Blood 2012; 121: 1469–1476.

    Article  Google Scholar 

  4. Bone Marrow Donors Worldwide. http://www.bmdw.org (accessed on 1st May, 2013).

  5. Sencer SF, Zhou T, Freedman LS, Ives JA, Chen Z, Wall D et al. Traumeel S in preventing and treating mucositis in young patients undergoing SCT: a report of the Children’s Oncology Group. Bone Marrow Transplant 2012; 47: 1409–1414.

    Article  CAS  Google Scholar 

  6. Craddock C, Labopin M, Pillai S, Finke J, Bunjes D, Greinix H et al. Factors predicting outcome after unrelated donor stem cell transplantation in primary refractory acute myeloid leukaemia. Leukemia 2011; 25: 808–813.

    Article  CAS  Google Scholar 

  7. Heemskerk MB, van Walraven SM, Cornelissen JJ, Barge RM, Bredius RG, Egeler RM et al. How to improve the search for an unrelated haematopoietic stem cell donor. Faster is better than more!. Bone Marrow Transplant 2005; 35: 645–652.

    Article  CAS  Google Scholar 

  8. Lown RN, Shaw BE . 'First do no harm': where do we stand on unrelated hematopoietic cell donor safety? Expert Rev Hematol 2012; 5: 249–252.

    Article  CAS  Google Scholar 

  9. Abress L . Retention Strategies. http://www.worldmarrow.org/fileadmin/Committees/EDUC/2011-EDUC/20111103-EDUC-Donor_Retention_NMDP.pdf (accessed on 1st May, 2013).

  10. Switzer GE, Dew MA, Stukas AA, Goycoolea JM, Hegland J, Simmons RG . Factors associated with attrition from a national bone marrow registry. Bone Marrow Transplant 1999; 24: 313–319.

    Article  CAS  Google Scholar 

  11. Werzner ASU, Stolze J, Cotta L, Schmidt A, Ehninger G Patient-Related Donor Recruitment Increases Donor Availability On CT Level, http://www.worldmarrow.org/fileadmin/Committees/EDUC/2012-EDUC/20121108-EDUC-Abstracts_Edu_day.pdf (accessed on 16th December, 2013).

  12. Chen AI, Negrin RS, McMillan A, Shizuru JA, Johnston LJ, Lowsky R et al. Tandem chemo-mobilization followed by high-dose melphalan and carmustine with single autologous hematopoietic cell transplantation for multiple myeloma. Bone Marrow Transplant 2012; 47: 516–521.

    Article  CAS  Google Scholar 

  13. Direkze S, Mansour M, Rodriguez-Justo M, Kibbler C, Gant V, Peggs KS . Candida kefyr fungal enteritis following autologous BMT. Bone Marrow Transplant 2012; 47: 465–466.

    Article  CAS  Google Scholar 

  14. Switzer GE, Myaskovsky L, Goycoolea JM, Dew MA, Confer DL, King R . Factors associated with ambivalence about bone marrow donation among newly recruited unrelated potential donors. Transplantation 2003; 75: 1517–1523.

    Article  Google Scholar 

  15. Schmidt AH, Biesinger L, Baier D, Harf P, Rutt C . Aging of registered stem cell donors: implications for donor recruitment. Bone Marrow Transplant 2008; 41: 605–612.

    Article  CAS  Google Scholar 

  16. Muller CR, Ehninger G, Goldmann SF . Gene and haplotype frequencies for the loci hLA-A, hLA-B, and hLA-DR based on over 13 000 German blood donors. Hum Immunol 2003; 64: 137–151.

    Article  Google Scholar 

  17. Kollman C, Abella E, Baitty RL, Beatty PG, Chakraborty R, Christiansen CL et al. Assessment of optimal size and composition of the US National Registry of hematopoietic stem cell donors. Transplantation 2004; 78: 89–95.

    Article  Google Scholar 

  18. Laver JH, Hulsey TC, Jones JP, Gautreaux M, Barredo JC, Abboud MR . Assessment of barriers to bone marrow donation by unrelated African-American potential donors. Biol Blood Marrow Transplant 2001; 7: 45–48.

    Article  CAS  Google Scholar 

  19. Ballen KK, Hicks J, Dharan B, Ambruso D, Anderson K, Bianco C et al. Racial and ethnic composition of volunteer cord blood donors: comparison with volunteer unrelated marrow donors. Transfusion 2002; 42: 1279–1284.

    Article  Google Scholar 

  20. Schmidt AH, Solloch UV, Baier D, Yazici B, Ozcan M, Stahr A et al. Criteria for initiation and evaluation of minority donor programs and application to the example of donors of Turkish descent in Germany. Bone Marrow Transplant 2009; 44: 405–412.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R N Lown.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lown, R., Marsh, S., Switzer, G. et al. Ethnicity, length of time on the register and sex predict donor availability at the confirmatory typing stage. Bone Marrow Transplant 49, 525–531 (2014). https://doi.org/10.1038/bmt.2013.206

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2013.206

Keywords

This article is cited by

Search

Quick links