IMMUNOGENETIC MARROW DONOR SEARCH FOR 1012 PATIENTS - A RETROSPECTIVEANALYSIS OF STRATEGIES, OUTCOME AND COSTS

To analyse strategies, outcome and costs of immunogenetic marrow donor search 1012 patients were enrolled in a retrospective single centre s tudy covering the period from January 1990 to December 1992. An HLA-co mpatible donor was identified for 562 of the patients (55.4%). Core fa mily donor search (CFDS) provided a donor for 39%, extended family don or search (EFDS) for 6.4% and unrelated marrow donor search (UMDS) for 10% of the patients. During the period analysed, UMDS success rate in creased from 13.3% to 47.8%, while mean search length decreased from 7 .2 to 4.8 months. The percentage of donors from German registries rose from 5% in 1990 to 50% in 1993. Search length was dependent on patien t's HLA phenotype frequency, but even for patients with frequencies as low as <1:3 000 000 a donor was found in 5 of 24 cases. The mean cost s (DM) per donor identified by CFDS, EFDS and UMDS were 2921, 19 172 a nd 24 036, respectively. Thus, CFDS is the utmost effective type of se arch. In view of the clinical outcome of BMT, EFDS remains a meaningfu l strategy and should not be replaced by UMDS despite its increasing s uccess rate.