NMDP Expedited Search Process: Selection, Typing and Transplant (STaT)

Aims Patients transplanted earlier in their disease have better outcomes. Haploidentical transplants continue to increase in part due to the time in finding a donor and cost associated with unrelated donor transplant. We aimed to determine if the National Marrow Donor Program (NMDP) could consistently deliver an available and health screened donor ready to be requested for workup in 14 calendar days for patients in need of an urgent transplant and meet the transplant center's (TC) targeted collection date. Methods Three USA TCs enrolled patients in need of an urgent transplant, defined as Results To date, 72 patients enrolled in the STaT process. For patients with donors requested for testing, 54/60 (90%) were delivered a workup ready donor within 14 calendar days. Thirty-four patients proceeded to transplant with a median time of 70 days (range 22-211; 2 directly to work up). Of those transplanted, 5 (15%) met the targeted timeline to transplant, 21 (61%) had patient related delays, 3 (9%) had a delay in finding a suitable donor, 3 (9%) had TC delays, and 2 (6%) had difficulty finding an AC/CC. Thirty-four (47%) of the patients did not proceed to transplant and no longer have an active search for reasons including: patient was no longer a transplant candidate, an alternate source was selected (cord blood, haplo), or patient treatment plan changed. Currently, 4 patients are on hold with patient related delays. Conclusions In a majority of cases NMDP can deliver a workup ready unrelated donor for an urgent patient timeline. However, even with a donor ready to proceed to workup many delays occur, with most being patient related. Rapid time to transplant can be successful however, additional process improvements by registries and TCs are needed to optimize the process.