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Urgent Time to Allogeneic Hematopoietic Cell Transplantation: A National Survey of Transplant Physicians and Unrelated Donor Search Coordinators Facilitated by the Histocompatibility Advisory Group to the National Marrow Donor Program.

Abstract

To characterize donor search and selection practices, the National Marrow Donor Program (NMDP) Histocompatibility Advisory Group developed a survey of allogeneic hematopoietic cell transplant (HCT) physicians and search coordinators. The objectives were to describe search practices, understand practices surrounding urgent time to HCT, and characterize strategies used when identifying a matched unrelated donor is unlikely. Participants included US physician members of the American Society for Transplantation and Cellular Therapy and donor search coordinators within the NMDP network. The web-based survey was conducted from February to May 2018. Three hundred seventeen of 858 physicians (37%) and 225 of 327 coordinators (69%) responded, of which 263 and 194, respectively, were eligible and included in the analysis. Most centers, 142 (95%), were represented; 108 (72%) had at least 1 physician and 128 (85%) had at least 1 coordinator respondent. Most (68% physicians, 61% coordinators) indicated donor selection decisions were made by individual physicians. Urgent time to HCT was most commonly (90% and 87% of physicians and coordinators, respectively) defined as HCT within 4 to 6 weeks of search initiation. Higher HCT urgency was associated with a higher disease risk index. For urgent cases with low probability of an 8/8 matched unrelated donor , 75% and 80% of physicians and coordinators endorsed a short (1 to 2 weeks) unrelated donor search before proceeding to an alternative donor source. NMDP-provided solutions to expedite donor identification were strongly endorsed. This survey clarified current donor selection practices in the United States and defined urgent time to HCT. These data provide insight to NMDP on potential solutions to support the path to transplant, such as highlighting futile searches and providing alternative donor options at the time of search initiation.

Authors+Show Affiliations

Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida. Electronic address: joepidala@yahoo.com.National Marrow Donor Program, Minneapolis, Minnesota; Center for International Blood and Marrow Transplant Research, Minneapolis, Mimmesota.National Marrow Donor Program, Minneapolis, Minnesota.Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.Department of Pathology, Stanford School of Medicine, Palo Alto, California.National Marrow Donor Program, Minneapolis, Minnesota; Center for International Blood and Marrow Transplant Research, Minneapolis, Mimmesota.National Marrow Donor Program, Minneapolis, Minnesota.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31419569

Citation

Pidala, Joseph, et al. "Urgent Time to Allogeneic Hematopoietic Cell Transplantation: a National Survey of Transplant Physicians and Unrelated Donor Search Coordinators Facilitated By the Histocompatibility Advisory Group to the National Marrow Donor Program." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 2019.
Pidala J, Mupfudze TG, Payton T, et al. Urgent Time to Allogeneic Hematopoietic Cell Transplantation: A National Survey of Transplant Physicians and Unrelated Donor Search Coordinators Facilitated by the Histocompatibility Advisory Group to the National Marrow Donor Program. Biol Blood Marrow Transplant. 2019.
Pidala, J., Mupfudze, T. G., Payton, T., Barker, J., Perales, M. A., Shaw, B. E., ... Dehn, J. (2019). Urgent Time to Allogeneic Hematopoietic Cell Transplantation: A National Survey of Transplant Physicians and Unrelated Donor Search Coordinators Facilitated by the Histocompatibility Advisory Group to the National Marrow Donor Program. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, doi:10.1016/j.bbmt.2019.08.002.
Pidala J, et al. Urgent Time to Allogeneic Hematopoietic Cell Transplantation: a National Survey of Transplant Physicians and Unrelated Donor Search Coordinators Facilitated By the Histocompatibility Advisory Group to the National Marrow Donor Program. Biol Blood Marrow Transplant. 2019 Aug 13; PubMed PMID: 31419569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urgent Time to Allogeneic Hematopoietic Cell Transplantation: A National Survey of Transplant Physicians and Unrelated Donor Search Coordinators Facilitated by the Histocompatibility Advisory Group to the National Marrow Donor Program. AU - Pidala,Joseph, AU - Mupfudze,Tatenda G, AU - Payton,Tammy, AU - Barker,Juliet, AU - Perales,Miguel-Angel, AU - Shaw,Bronwen E, AU - Fernández-Viña,Marcelo, AU - Burns,Linda J, AU - Dehn,Jason, Y1 - 2019/08/13/ PY - 2019/05/08/received PY - 2019/08/07/revised PY - 2019/08/07/accepted PY - 2019/8/17/pubmed PY - 2019/8/17/medline PY - 2019/8/17/entrez KW - Allogeneic donors KW - Allogeneic hematopoietic cell transplantation KW - Donor selection KW - National Marrow Donor Program KW - Urgent time to transplant JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol. Blood Marrow Transplant. N2 - To characterize donor search and selection practices, the National Marrow Donor Program (NMDP) Histocompatibility Advisory Group developed a survey of allogeneic hematopoietic cell transplant (HCT) physicians and search coordinators. The objectives were to describe search practices, understand practices surrounding urgent time to HCT, and characterize strategies used when identifying a matched unrelated donor is unlikely. Participants included US physician members of the American Society for Transplantation and Cellular Therapy and donor search coordinators within the NMDP network. The web-based survey was conducted from February to May 2018. Three hundred seventeen of 858 physicians (37%) and 225 of 327 coordinators (69%) responded, of which 263 and 194, respectively, were eligible and included in the analysis. Most centers, 142 (95%), were represented; 108 (72%) had at least 1 physician and 128 (85%) had at least 1 coordinator respondent. Most (68% physicians, 61% coordinators) indicated donor selection decisions were made by individual physicians. Urgent time to HCT was most commonly (90% and 87% of physicians and coordinators, respectively) defined as HCT within 4 to 6 weeks of search initiation. Higher HCT urgency was associated with a higher disease risk index. For urgent cases with low probability of an 8/8 matched unrelated donor , 75% and 80% of physicians and coordinators endorsed a short (1 to 2 weeks) unrelated donor search before proceeding to an alternative donor source. NMDP-provided solutions to expedite donor identification were strongly endorsed. This survey clarified current donor selection practices in the United States and defined urgent time to HCT. These data provide insight to NMDP on potential solutions to support the path to transplant, such as highlighting futile searches and providing alternative donor options at the time of search initiation. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/31419569/Urgent_Time_to_Allogeneic_Hematopoietic_Cell_Transplantation:_A_National_Survey_of_Transplant_Physicians_and_Unrelated_Donor_Search_Coordinators_Facilitated_by_the_Histocompatibility_Advisory_Group_to_the_National_Marrow_Donor_Program L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(19)30516-6 DB - PRIME DP - Unbound Medicine ER -