NMDP Donor for All initiative

Unlocking access to life-saving treatment

In the past, having an 8/8 human leukocyte antigen (HLA)-matched donor was crucial for the best hematopoietic cell transplant (HCT) outcomes. The problem: even though every search in partnership with NMDP℠ provides patients access to more than 41 million potential donors worldwide, not every patient in need has a full match—especially those with ethnically diverse ancestries.

At NMDP, we refuse to accept the status quo. We’re on a mission to unlock access to treatment through innovative research that significantly expands options for suitable donors for those without a fully matched donor.

Because even though we're actively working to remove barriers to donation and address the historical underrepresentation of diverse ethnic backgrounds on the NMDP Registry^SM, registry member recruitment efforts alone won’t solve the need. Science will.

Transplant recipient, Johanna, with her donor, Catherine

Increasing the odds for all patients

Our Donor for All initiative includes many research efforts that aim to establish a new safe and effective approach for using mismatched unrelated donor (MMUD) transplants in the U.S. and abroad.

This will significantly increase the odds that patients with diverse ancestry will find a suitably matched available donor on the NMDP Registry—all while providing equal outcomes comparable to current survival rates with an 8/8 matched donor. Explore the work that's increasing the odds your patient will find a life-saving match.

Then connect with a NMDP clinical operations partner in your region to discuss the Donor for All initiative and how you can get involved.

Breakthrough research brings life-saving treatments to more patients

Watch this video for additional background on why MMUD transplant research is critical and take a closer look at the 15-MMUD clinical trial results.

Watch A Donor For All

Donor for All initiative clinical trials

NMDP is sponsoring a series of Phase II clinical trials conducted by CIBMTR^® (Center for International Blood and Marrow Transplant Research^®) studying the use of post-transplant cyclophosphamide (PTCy) graft-versus-host disease (GVHD) prophylaxis in MMUD HCT (patients matched at 4/8 to 7/8 alleles). CIBMTR is a research collaboration between the Medical College of Wisconsin^® and NMDP.

The three clinical trials were designed to be as inclusive as possible. Approximately 50% of those enrolled in the 15-MMUD and ACCESS clinical trials have ethnically diverse ancestries. Historical enrollment in HCT clinical trials has been less than 20% ethnically diverse ancestry. The OPTIMIZE clinical trial enrolled its first patient in January 2024.

15-MMUD clinical trial

The first multicenter trial developed to evaluate the effectiveness of PTCy in the setting of MMUD HCT, adult patients in the 15-MMUD trial received bone marrow from a MMUD. The results exceeded expectations with outcomes up to three years post-HCT comparing favorably to historical 8/8 HCT.

15-MMUD trial results

ACCESS clinical trial

Adult patients in the ACCESS trial receive peripheral blood stem cells (PBSCs) and pediatric patients receive bone marrow from a MMUD. The adult strata completed enrollment; the pediatric strata remains open. Presented at the 2024 ASCO Annual Meeting, early results from a subset of 70 primarily older adult patients show positive outcomes.

ACCESS trial details

OPTIMIZE clinical trial

Adult patients who enroll in the open OPTIMIZE clinical trial receive PBSCs from a MMUD and a reduced dose of PTCy. The study aims to understand if the reduced dose can lower infections while maintaining GVHD protection.

OPTIMIZE trial details

Donor for All initiative observational studies

Observational studies through CIBMTR indicate the use of MMUDs will truly make a difference in equalizing outcomes and expanding access for patients.

PTCy equalizes MUD and MMUD HCT outcomes

Research from CIBMTR published in the Journal of Clinical Oncology shows that with PTCy, the outcomes between 8/8 matched and 7/8 matched unrelated donor transplant are equivalent. They found no significant differences in overall survival (OS) or GVHD-free, relapse-free survival (GRFS) between the two groups.

Review the study

MMUDs expand access for nearly 100% of patients

CIBMTR found that allowing for a 5/8 HLA match level could bridge the donor availability gap for those with diverse ancestry. Using a 5/8 match level increased the NMDP Registry coverage to greater than 99% for all groups even when considering only donors who are 35 years old and younger.

Review the study

Access additional research summaries.

Articles and news

NMDP is dedicated to spreading the word that MMUD HCT is proving to be safe and effective and encouraging practice change at hematology/oncology practices, transplant centers and international registries.

Evolution of HCT to overcome access disparities

In this paper published in Cells, NMDP Chief Medical Officer and CIBMTR Senior Scientific Director Steven Devine, MD, explores the recent work of NMDP to address access gaps in HCT by improving MMUD outcomes. He shares the evolution of matched and mismatched unrelated HCT over the years.

Read the paper

Breaking HLA-related barriers in alloHCT

In this article published in The Hematologist, NMDP Chief Medical Officer and CIBMTR Senior Scientific Director Steven Devine, MD, explores MMUD HCT research, including how PTCy and the FDA-approved abatacept for acute GVHD prevention are shifting the treatment paradigm.

Read the article

PTCy offers new hope for MMUD HCT

In an interview with Targeted Oncology, NMDP Senior Vice President of Health Equity and CIBMTR Chief Scientific Officer Jeff Auletta, MD, discusses how PTCy is offering a promising approach for expanding HCT access regardless of match level or a patient’s ethnicity.

Read the interview

Explore additional Donor for All articles and news:

Bone marrow donors needn’t be perfect match, study says, paving way for more equitable access

NMDP and CIBMTR to present new promising stem cell transplantation trial data using mismatched unrelated donors at 2024 ASCO annual meeting

NMDP announces enrollment of first patient in OPTIMIZE clinical trial

Is finding a donor for all in need of allogeneic HCT possible? New modeling says yes

Contact our team

Questions about the Donor for All initiative, MMUD clinical trials or how you can get involved? Talk to your NMDP clinical operations partner or fill out the form and a clinical operations partner in your region will connect with you.