Matched Unrelated Donor
The Cancer Center has one of the few programs approved in New York State to perform matched unrelated donor bone marrow transplants for patients with lymphoblastic or myeloid leukemia, Hodgkin's or non-Hodgkin's lymphoma and other blood disorders. It is also one of a select group of centers nationally capable of performing DNA matching of potential donors on site.
Bone Marrow Transplantation is used to treat several kinds of leukemia, lymphoma, Hodgkin's disease, renal cell, breast and ovarian cancers, as well as nonmalignant blood disorders such as aplastic anemia. In some cases, bone marrow must be replaced because it has been destroyed by high-dose chemotherapy; in other cases, the bone marrow itself is diseased. Stem cell bone marrow is responsible for making the red blood cells that carry oxygen, the white blood cells that fight infection and the platelets that help the blood to clot.
For many patients with acute lymphoblastic or myeloid leukemia, Hodgkin's or non-Hodgkin's lymphoma and other blood disorders, an allogeneic (or donor) bone marrow transplant from a genetically matched donor offers the only hope for a cure. The ideal donor is a genetically identical sibling. For the majority of these patients, however, there will be no sibling whose bone marrow is a suitable match since there is only a one-in-four chance that any sibling will have the same HLA-type as the patient (recipient). The next best option for those without matched siblings is transplantation from an unrelated, but HLA-matched, donor. The Cancer Center has one of the few programs in New York State approved to perform this life-saving procedure.
The Cancer Center is also one of a select group of centers nationwide to offer DNA matching of potential bone marrow donors on site, rather than sending the blood sample out for analysis. Providing this sophisticated analysis on site enables physicians to match a donor to the patient more quickly. In addition, there are currently more than three million volunteer bone marrow and stem cell donors listed with the National Marrow Donor Programs (NMDP) national donor registry, so the odds of finding an unrelated matched donor have improved substantially.
Finding a Match
It takes approximately two to three months to find an appropriately matched unrelated bone marrow donor and arrange a transplant. Physicians begin by performing HLA typing on the blood of the patient's siblings. If there is no sibling match, the patient's HLA-type is then fed into a computer, which produces a printout of potential donors from around the world. In general, physicians prefer younger, male donors because women who have given birth have more antibodies present in their blood.
The most promising donors then go to a local bone marrow collection center (Westchester Medical Center is also a designated Collection Center) and have their blood drawn to confirm the six-out-of-six HLA match, and to enable clinicians at the Cancer Center to perform DNA matching. The selected donor then has a physical examination with a community physician arranged by the NMDP to screen for communicable diseases and any other contraindications. Once the donor has been approved, a date is proposed for the transplant.