French national bone marrow donor registry and interaction with foreign files

Area of Science:

• Hematology
• Immunogenetics
• Transplantation Medicine

Background:

• Establishing a robust volunteer bone marrow donor registry is crucial for patients requiring hematopoietic stem cell transplantation.
• Human Leukocyte Antigen (HLA) matching significantly impacts transplant success rates and patient outcomes.
• Chronic myelogenous leukemia (CML) is a primary indication for bone marrow transplantation.

Purpose of the Study:

• To describe the development and initial outcomes of a program aimed at recruiting volunteer bone marrow donors.
• To assess the feasibility of identifying HLA-A, B, and DR identical donors for patients in need of transplantation.
• To evaluate the efficiency of donor searches for patients with various hematological malignancies.

Main Methods:

• Implementation of a volunteer donor recruitment program.
• Performance of Human Leukocyte Antigen (HLA)-A and B typing for 33,000 potential donors.
• Initiation of donor searches for 527 patients, including those with chronic myelogenous leukemia.
• Mixed lymphocyte culture (MLC) assays to assess donor-recipient compatibility.

Main Results:

• A total of 33,000 HLA-A, B typings were completed.
• Donor searches were initiated for 527 patients, with 44% diagnosed with chronic myelogenous leukemia.
• No HLA-A, B identical donor was found for 23% of patients.
• Among patients with an HLA-A, B identical donor, 35% had a fully HLA-A, B, DR identical donor.
• Transplantation was proposed for 20 out of 79 patients after MLC testing at one center.
• Transplantations have been performed in 31 patients to date.

Conclusions:

• The developed program successfully recruited a significant number of potential bone marrow donors.
• The HLA typing and donor search process identified compatible donors for a substantial portion of patients.
• Further optimization of donor registries and HLA matching strategies is essential to improve transplant accessibility.