Unrelated bone marrow transplantation from the National Marrow Donor Program

Between November 1992 and December 1996, we carried out bone marrow transplantation through the National Marrow Donor Program (NMDP) for 11 patients who lacked an appropriate donor among their family members and the Japan Marrow Donor Program (JMDP). They accounted for 11% of 101 patients who had registrated to the NMDP Transplant Center Office in Japan. The median time required from the initiation of preliminary search to transplant for these 11 patients was 198 days. The 11 donors included four Caucasians, one Native American and the others were Asian/Pacific islanders. A median of 17 h was required to transport bone marrow from harvest institutes to our hospital and their viability determined in our laboratory had a median of 96%. Engraftment was observed in all recipients and the incidence of grade III-IV acute graft-versus host disease was 27%. Of four patients three (75%) with chronic myelogenous leukemia in chronic phase (standard-risk) and two (29%) of seven patients in progressive state of the disease (high-risk), are alive at present. Cooperation between the JMDP and the NMDP, which began in April 1997, could shorten the time for donor search and allow transplantation to more patients with more appropriate timing.