Donor Policies for Hematopoietic Stem Cell Transplantation

  • Donne Bennett D. Caces
  • Koen Van Besien
  • Andrew S. Artz
  • Lucy A. Godley
Part of the Stem Cells and Cancer Stem Cells book series (STEM, volume 6)


With the advent of more sophisticated transplantation techniques and rapid advancements in supportive care, allogeneic hematopoietic stem cell transplantation has become part of standard therapy for a variety of hematologic diseases. Improvements in allogeneic transplant outcomes are due largely to our enhanced capability of identifying better-matched donors. Donor-recipient HLA-matching remains of paramount importance in minimizing transplant-associated risks. Policies that safeguard donor welfare should focus on the establishment of adequate screening procedures and optimal stem cell harvesting strategies to minimize risks to the donor. The development of a protocol for the mobilization and collection of peripheral blood stem cells streamlined the donorship process and provided a less traumatic alternative to bone marrow harvesting. For patients without an adequately matched donor, umbilical cord blood is increasingly being utilized as an alternative source of hematopoietic stem cells despite the unique challenges associated with its maintenance, storage, and transport. As hematopoietic transplantation forges forward, issues pertaining to international donorship and donor compensation will need to be addressed.


Human Leukocyte Antigen Hematopoietic Stem Cell Transplantation West Nile Virus Umbilical Cord Blood Peripheral Blood Stem Cell 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Ballen KK, King RJ, Chitphakdithai P, Bolan CD Jr, Agura E, Hartzman RJ, Kernan NA (2008) The National Marrow Donor Program 20 years of unrelated donor hematopoietic cell transplantation. Biol Blood Marrow Transplant 14:2–7PubMedCrossRefGoogle Scholar
  2. Bensinger WI, Martin PJ, Storer B, Clift R, Forman SJ, Negrin R, Kashyap A, Flowers ME, Lilleby K, Chauncey TR, Storb R, Appelbaum FR (2001) Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers. N Engl J Med 344:175–181PubMedCrossRefGoogle Scholar
  3. Bioethics CO (2010) Children as hematopoietic stem cell donors. Pediatrics 125:392–404CrossRefGoogle Scholar
  4. Bolan CD, Hartzman RJ, Perry EH, Trainor L, Miller J, Miller R, Hanley L, Chitphakdithai P, King RJ (2008) Donation activities and product integrity in unrelated donor allogeneic hematopoietic transplantation: experience of the National Marrow Donor Program. Biol Blood Marrow Transplant 14:23–28PubMedCrossRefGoogle Scholar
  5. Boo M, van Walraven SM, Chapman J, Lindberg B, Schmidt AH, Shaw BE, Switzer GE, Yang E, Egeland T (2011) Remuneration of hematopoietic stem cell donors: principles and perspective of the World Marrow Donor Association. Blood 117:21–25PubMedCrossRefGoogle Scholar
  6. Bosi A, Bartolozzi B (2010) Safety of bone marrow stem cell donation: a review. Transplant Proc 42:2192–2194PubMedCrossRefGoogle Scholar
  7. Bray RA, Hurley CK, Kamani NR, Woolfrey A, Muller C, Spellman S, Setterholm M, Confer DL (2008) National Marrow Donor Program HLA matching guidelines for unrelated adult donor hematopoietic cell transplants. Biol Blood Marrow Transplant 14:45–53PubMedCrossRefGoogle Scholar
  8. Buijs A, Poddighe P, van Wijk R, van Solinge W, Borst E, Verdonck L, Hagenbeek A, Pearson P, Lokhorst H (2001) A novel CBFA2 single-nucleotide mutation in familial platelet disorder with propensity to develop myeloid malignancies. Blood 98:2856–2858PubMedCrossRefGoogle Scholar
  9. Cashen AF, Lazarus HM, Devine SM (2007) Mobilizing stem cells from normal donors: is it possible to improve upon G-CSF? Bone Marrow Transplant 39:577–588PubMedCrossRefGoogle Scholar
  10. Churpek JE, Onel K (2010) Heritability of hematologic malignancies: from pedigrees to genomics. Hematol Oncol Clin North Am 24:939–972PubMedCrossRefGoogle Scholar
  11. Devine SM, Vij R, Rettig M, Todt L, McGlauchlen K, Fisher N, Devine H, Link DC, Calandra G, Bridger G, Westervelt P, Dipersio JF (2008) Rapid mobilization of functional donor hematopoietic cells without G-CSF using Amd3100, an antagonist of the CXCR4/SDF-1 interaction. Blood 112:990–998PubMedCrossRefGoogle Scholar
  12. Foeken LM, Green A, Hurley CK, Marry E, Wiegand T, Oudshoorn M (2010) Monitoring the international use of unrelated donors for transplantation: the WMDA annual reports. Bone Marrow Transplant 45:811–818PubMedCrossRefGoogle Scholar
  13. Heinrichs H, Orr HT (1990) HLA non-A, B, C class I genes: their structure and expression. Immunol Res 9:265–274PubMedCrossRefGoogle Scholar
  14. Hurley CK, Wagner JE, Setterholm MI, Confer DL (2006) Advances in HLA: practical implications for selecting adult donors and cord blood units. Biol Blood Marrow Transplant 12:28–33PubMedCrossRefGoogle Scholar
  15. Ilhan O, Arslan O, Arat M, Beksac M, Akan H, Ozcan M, Gurman G, Konuk N, Uysal A, Koc H (1999) The impact of the CD34+ cell dose on engraftment in allogeneic peripheral blood stem cell transplantation. Transfus Sci 20:69–71PubMedCrossRefGoogle Scholar
  16. Karanes C, Nelson GO, Chitphakdithai P, Agura E, Ballen KK, Bolan CD, Porter DL, Uberti JP, King RJ, Confer DL (2008) Twenty years of unrelated donor hematopoietic cell transplantation for adult recipients facilitated by the National Marrow Donor Program. Biol Blood Marrow Transplant 14:8–15PubMedCrossRefGoogle Scholar
  17. Korbling M, Fliedner TM (1996) The evolution of clinical peripheral blood stem cell transplantation. Bone Marrow Transplant 17:675–678PubMedGoogle Scholar
  18. Korbling M, Freireich EJ (2011) Twenty-five years of peripheral blood stem cell transplantation. Blood 117:6411–6416PubMedCrossRefGoogle Scholar
  19. Lee SJ, Klein J, Haagenson M, Baxter-Lowe LA, Confer DL, Eapen M, Fernandez-Vina M, Flomenberg N, Horowitz M, Hurley CK, Noreen H, Oudshoorn M, Petersdorf E, Setterholm M, Spellman S, Weisdorf D, Williams TM, Anasetti C (2007) High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation. Blood 110:4576–4583PubMedCrossRefGoogle Scholar
  20. McCullough J, McKenna D, Kadidlo D, Maurer D, Noreen HJ, French K, Brunstein C, Wagner JE (2009) Mislabeled units of umbilical cord blood detected by a quality assurance program at the transplantation center. Blood 114:1684–1688PubMedCrossRefGoogle Scholar
  21. Miller JP, Perry EH, Price TH, Bolan CD Jr, Karanes C, Boyd TM, Chitphakdithai P, King RJ (2008) Recovery and safety profiles of marrow and PBSC donors: experience of the National Marrow Donor Program. Biol Blood Marrow Transplant 14:29–36PubMedCrossRefGoogle Scholar
  22. Mohty M, Bilger K, Jourdan E, Kuentz M, Michallet M, Bourhis JH, Milpied N, Sutton L, Jouet JP, Attal M, Bordigoni P, Cahn JY, Sadoun A, Ifrah N, Guyotat D, Faucher C, Fegueux N, Reiffers J, Maraninchi D, Blaise D (2003) Higher doses of Cd34+ peripheral blood stem cells are associated with increased mortality from chronic graft-versus-host disease after allogeneic HLA-identical sibling transplantation. Leukemia 17:869–875PubMedCrossRefGoogle Scholar
  23. Nakamura R, Auayporn N, Smith DD, Palmer J, Sun JY, Schriber J, Pullarkat V, Parker P, Rodriguez R, Stein A, Rosenthal J, Wang S, Karanas C, Gaal K, Senitzer D, Forman SJ (2008) Impact of graft cell dose on transplant outcomes following unrelated donor allogeneic peripheral blood stem cell transplantation: higher Cd34+ cell doses are associated with decreased relapse rates. Biol Blood Marrow Transplant 14:449–457PubMedCrossRefGoogle Scholar
  24. NMDP (2010) Draft 21st edition standards and glossary (N. M. D. Program, ed), pp 49
  25. O’Donnell PV, Pedersen TL, Confer DL, Rizzo JD, Pulsipher MA, Stroncek D, Leitman S, Anderlini P (2010) Practice patterns for evaluation, consent, and care of related donors and recipients at hematopoietic cell transplantation centers in the United States. Blood 115:5097–5101PubMedCrossRefGoogle Scholar
  26. Pulsipher MA, Chitphakdithai P, Miller JP, Logan BR, King RJ, Rizzo JD, Leitman SF, Anderlini P, Haagenson MD, Kurian S, Klein JP, Horowitz MM, Confer DL (2009) Adverse events among 2408 unrelated donors of peripheral blood stem cells: results of a prospective trial from the National Marrow Donor Program. Blood 113:3604–3611PubMedCrossRefGoogle Scholar
  27. Richa E, Papari M, Allen J, Martinez G, Wickrema A, Anastasi J, Van Besien K, Artz A (2009) Older age but not donor health impairs allogeneic granulocyte colony-stimulating factor (G-CSF) peripheral blood stem cell mobilization. Biol Blood Marrow Transplant 15:1394–1399PubMedCrossRefGoogle Scholar
  28. Rubinstein P (2009) Cord blood banking for clinical transplantation. Bone Marrow Transplant 44:635–642PubMedCrossRefGoogle Scholar
  29. Sasazuki T, Juji T, Morishima Y, Kinukawa N, Kashiwabara H, Inoko H, Yoshida T, Kimura A, Akaza T, Kamikawaji N, Kodera Y, Takaku F (1998) Effect of matching of class I HLA alleles on clinical outcome after transplantation of hematopoietic stem cells from an unrelated donor. Japan Marrow Donor Program. N Engl J Med 339:1177–1185PubMedCrossRefGoogle Scholar
  30. Schmitz N, Beksac M, Hasenclever D, Bacigalupo A, Ruutu T, Nagler A, Gluckman E, Russell N, Apperley JF, Gorin NC, Szer J, Bradstock K, Buzyn A, Clark P, Borkett K, Gratwohl A (2002) Transplantation of mobilized peripheral blood cells to HLA-identical siblings with standard-risk leukemia. Blood 100:761–767PubMedCrossRefGoogle Scholar
  31. Sevilla J, Gonzalez-Vicent M, Lassaletta A, Ramirez M, Perez-Martinez A, Madero L, Diaz MA (2009) Peripheral blood progenitor cell collection adverse events for childhood allogeneic donors: variables related to the collection and safety profile. Br J Haematol 144:909–916PubMedCrossRefGoogle Scholar
  32. Spellman S, Bray R, Rosen-Bronson S, Haagenson M, Klein J, Flesch S, Vierra-Green C, Anasetti C (2010) The detection of donor-directed, HLA-specific alloantibodies in recipients of unrelated hematopoietic cell transplantation is predictive of graft failure. Blood 115:2704–2708PubMedCrossRefGoogle Scholar
  33. To LB, Haylock DN, Simmons PJ, Juttner CA (1997) The biology and clinical uses of blood stem cells. Blood 89:2233–2258PubMedGoogle Scholar
  34. Woolfrey A, Klein JP, Haagenson M, Spellman S, Petersdorf E, Oudshoorn M, Gajewski J, Hale GA, Horan J, Battiwalla M, Marino SR, Setterholm M, Ringden O, Hurley C, Flomenberg N, Anasetti C, Fernandez-Vina M, Lee SJ (2010) HLA-C antigen mismatch is associated with worse outcome in unrelated donor peripheral blood stem cell transplantation. Biol Blood Marrow Transplant 17:885–892PubMedCrossRefGoogle Scholar
  35. Zaucha JM, Gooley T, Bensinger WI, Heimfeld S, Chauncey TR, Zaucha R, Martin PJ, Flowers ME, Storek J, Georges G, Storb R, Torok-Storb B (2001) Cd34 Cell dose in granulocyte colony-stimulating factor-mobilized peripheral blood mononuclear cell grafts affects engraftment kinetics and development of extensive chronic graft-versus-host disease after human leukocyte antigen-identical sibling transplantation. Blood 98:3221–3227PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Donne Bennett D. Caces
    • 1
  • Koen Van Besien
    • 1
  • Andrew S. Artz
    • 1
  • Lucy A. Godley
    • 1
  1. 1.Department of MedicineUniversity of ChicagoChicagoUSA

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