UAB Synopsis, Vol. 26, No. 38, October 22, 2007

Survival Rates for Matched Unrelated Donor BMT Highest in Region

UAB’s 1-year survival rates for matched unrelated donor bone marrow transplants are the highest among major transplant centers in the region, outranking centers such as M.D. Anderson Cancer Center, Emory University, and Vanderbilt University.

The National Marrow Donor Program (NMDP), which locates almost all donors for matched unrelated bone marrow transplants performed in the United States, analyzes each center’s case mix to produce expected 1-year survival rates and reports the actual outcomes of all transplants it facilitates. UAB’s predicted 1-year survival for patients undergoing transplant during the last 5-year period analyzed (2000-2004) was 51.8%. Actual survival was 57.8%, exceeding the rate of the center with the next highest actual survival rate by more than 5% (see box on page 2).

The success of UAB’s Bone Marrow Transplantation and Cell Therapy Program (BMT&CT) is due largely to its single-staff model of care, says Director William P. Vaughan, MD, MBA, who instituted the system when he established UAB’s program in 1991.

“Under the single-staff model, a patient is cared for, 24 hours a day, 365 days a year, by the same team of physicians and nurses at every visit, whether inpatient or outpatient, or emergency visits,” Dr. Vaughan says.

He adds, “Patients also benefit from a highly structured set of transplant procedures and a stable faculty and staff, some of whom have been with the program since its inception.”

Allogeneic bone marrow transplantation has curative potential for various leuke­mias and lymphomas and a number of other malignant and nonmalignant disorders. However, only one in five patients will have a sibling who is a good human leukocyte antigen match.

Although the NMDP has more than 4 million registered volunteer donors, and the BMT&CT can access European registries, Dr. Vaughan says that suitable donors, particularly those from minority populations, always are in short supply.

UAB’s BMT&CT pediatric faculty and Children’s Hospital recently orchestrated a successful volunteer donor drive. The drive added more than 500 new blood and marrow donors to the NMDP registry in 2 days — the largest number of new donors produced by any comparable drive in the nation, Dr. Vaughan says. He notes that the drive’s donor pool included a large proportion of minority volunteers.