State of the Science in Ensuring a Donor for All

Explore Cell Therapy podcast season 2, episode 5

In this two-part "Explore Cell Therapy" podcast episode, Stephen Spellman, MBS, and Jeffery Auletta, MD, explain the current state of the science behind selecting an optimal donor source for allogeneic hematopoietic cell transplantation (HCT).

Listen as they discuss the latest research on HLA matching, the numerous graft sources available, and efforts to close equity gaps to ensure a donor is available for all patients who need allogeneic HCT as a potentially curative treatment option. You'll gain insights into the role both hematology/oncology practices and transplant centers play in improving HCT access for those who need it.

Key takeaways from this episode

1. Innovative new approaches—including the use of alternative donor sources and optimizing donor selection—have led to the ability to find a suitable donor for essentially every potential HCT patient.
2. Outcomes continue to improve for alternative and mismatched unrelated donor sources, which can expand HCT access and equity for patients less likely to find a fully matched donor.
3. Early referral to a transplant center can help address barriers to HCT by facilitating early HLA typing, enabling patient access to services and grants, and ensure ideal timing of transplant to optimize outcomes.
4. Research has uncovered important factors—like donor age and donor-specific antibodies—that can guide treatment decisions. Early consultation with a transplant center and the use of donor selection tools can aide these decisions to optimize donor selection and overall HCT outcomes.
5. Ongoing and future advances in HCT continue to improve event-free survival, increasing access and giving patients even more hope for the future.

This episode's expert guests

Stephen Spellman, MBS
Vice President of Research,NMDP
Senior Scientific Director, CIBMTR® (Center for International Blood and Marrow Transplant Research®)

Stephen Spellman is the Senior Scientific Director for the CIBMTR with oversight of the Graft Sources and Graft-Versus-Host Disease Working Committees. In addition, he is the principal investigator for the NMDP Research Sample Repository. His research focuses on immunogenetic and immunobiologic factors that influence transplant outcomes. He has authored/co-authored more than 200 publications.

Jeffery Auletta, MD
Senior Vice President, Patient Outcomes and Experience, NMDP
Chief Scientific Director, CIBMTR-NMDP

Jeffery Auletta, MD, has extensive clinical experience caring for HCT and immunocompromised patients. His research includes transplant immunology, infectious complications, supportive care, and immune-directed cellular therapies. Dr. Auletta is American board-certified in pediatrics, pediatric hematology/oncology, and pediatric infectious diseases.

 

 

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Read articles discussed in this episode 

• Hematology 2022—what is complete HLA match in 2022 (Hematology ASH Education Program, 2022)
• Racial disparities in access to alternative donor allografts persist in the era of "donors for all" (Blood Advances, 2022)
• Relationship of donor age and relationship to outcomes of haploidentical transplantation with posttransplant cyclophosphamide (Blood Advances, 2021)
• Development of an unrelated donor selection score predictive of survival after HCT: donor age matters most (Biology of Blood and Marrow Transplantation, 2018)
• The ASTCT-NMDP ACCESS initiative: a collaboration to address and sustain equal outcomes for all across the hematopoietic cell transplantation and cellular therapy ecosystem (Transplantation and Cellular Therapy, 2022)
• Selection of unrelated donors and cord blood units for hematopoietic cell transplantation: guidelines from the NMDP/CIBMTR (Blood, 2019)
• Strategies to advance the HCT source selection process (NMDP blog, 2020)

Resources for hematology/oncology and HCT physicians 

HCT Consultation Timing Guidelines
The HCT consultation timing guidelines from the NMDP and ASTCT identify appropriate referral timing for allogeneic or autologous HCT based on a patient's disease characteristics.

HLA Today
HLA Today provides no-cost HLA typing for patients and their family members at the time of diagnosis. This allows the process for finding a related or unrelated donor to begin as early as possible, even before a patient has a transplant consultation.

Transplant Center Directory for hematology/oncology physicians
This searchable database provides details on the transplant centers in the NMDP, such as center contact information, number of transplants by cell source, patient survival information and more.

ACCESS clinical trial information
Get ACCESS clinical trial information, including who is eligible, clinical trial details and clinical trial locations.

Data2Knowledge4Patients: ClinicalDecisioning Tools Under Development
Watch this webinar to understand how the CIBMTR and the NMDP are transforming data environments to better support clinical decision making.

Resources for your patients

NMDP Support Center
The NMDP Patient Support Center provides support, information and resources for transplant patients, caregivers and families. All our programs and resources are free.

Jason Carter Clinical Trials Search and Support Program
The Clinical Trials Search and Support Program helps patients find and join clinical trials through one-on-one support, an easy-to-navigate website, and financial assistance to help patients pay for travel costs to participate in a clinical trial.