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Outcomes of strategic alternative donor selection or suspending donor search based on Japan Marrow Donor Program coordination status

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Abstract

In allogeneic hematopoietic stem cell transplantation (allo-HSCT) from unrelated donors, delays in donor search are adversely associated with patient outcome. However, the optimal duration for either waiting for an unrelated donor or selecting alternative sources remains undetermined. Using data from the Japan Marrow Donor Program (JMDP) registry, we retrospectively analyzed 349 adult patients who had searched for unrelated donors. Two hundred and three patients received allo-HSCT from JMDP donors (Group A) with a median of 140 days required to identify a donor, 60 received allo-HSCT from alternative sources (Group B) after a median of 111.5 days at which point either all donor candidates had failed or the patient achieved a second or subsequent complete remission, and 77 suspended allo-HSCT (Group C) after a median of 310 days. The 5-year overall survival (OS) rate in Group A was superior to that of Group C (48.6 vs 38.5%, P = 0.001). Although Group B included more patients with high or very high disease risk index (DRI) at the time of allo-HSCT compared with Group A, the 5-year OS was not significantly different between Groups A and B (48.6 vs 40.9%, P = 0.07), indicating that switching to alternative donors may benefit patients with high DRI.

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Acknowledgements

We thank the members of the Japan Marrow Donor Program for generously providing donor search information. This work was supported in part by a Grant-in-Aid from the Ministry of Health, Labor, and Welfare, Japan (H26-Nanchi- (Immunology)-Ippan-101 and H28-Nanchi- (Immunology)-Ippan-101).

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Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, Aichi, 453-8511, Japan

    Naomi Kawashima, Naoko Shimizu, Sonoko Kamoshita, Kyoko Watakabe, Emi Yokohata, Shingo Kurahashi, Yukiyasu Ozawa & Koichi Miyamura

  2. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Naomi Kawashima, Satoshi Nishiwaki & Sonoko Kamoshita

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  1. Naomi Kawashima
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  2. Satoshi Nishiwaki
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  3. Naoko Shimizu
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  8. Yukiyasu Ozawa
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  9. Koichi Miyamura
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Correspondence to Naomi Kawashima.

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Kawashima, N., Nishiwaki, S., Shimizu, N. et al. Outcomes of strategic alternative donor selection or suspending donor search based on Japan Marrow Donor Program coordination status. Int J Hematol 107, 551–558 (2018). https://doi.org/10.1007/s12185-018-2413-7

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  • DOI: https://doi.org/10.1007/s12185-018-2413-7

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