THE CHANGING ACTIVITIES OF A REGIONAL MARROW DONOR PROGRAM

Background: A regional marrow donor program was established in 1982. F ollowing the establishment of the National Marrow Donor Program (NMDP) in 1987, the activities of this regional program changed. Study Desig n and Methods: To better understand the changes that occurred in the r egional marrow donor program, its donor recruitment and marrow collect ion activities through 1991 were studied retrospectively. Data analyze d included the total number of potential donors, the number and types of potential donors recruited each year, the number of searches perfor med, the number of samples collected for HLA-DR typing and mixed lymph ocyte culture testing, and the number of transplants in both programs from 1987 through 1991. Statistical analysis was performed by using ch i-square. Results: Initially, only persons who donated platelets by ap heresis were enrolled into the program. ln 1986, the regional program' s first drive to recruit people who were not apheresis donors occurred . The number of such drives increased each year, and in 1991, 12 drive s occurred, which resulted in the recruitment of 1313 potential marrow donors. From 1987 to 1991, the number of potential donors in the regi onal program grew from 3252 to 9146, but the proportion of apheresis d onors in the program decreased. In 1987, 91.9 percent of marrow donors at the regional center had been apheresis donors, but in 1991, 41.7 p ercent had been apheresis donors. The number of marrows donated at the regional center increased from 11 in 1987 to 29 in 1989, but then fel l to 24 per year in 1990 and 1991. The decrease in the number of donat ions at the regional program was due to the rapid growth in the NMDP f ile of potential marrow donors and the selection of donors whose HLA a ntigens were more compatible with those of the transplant recipients. In 1989, the regional program contained 4.6 percent of all HLA-A,B-typ ed and 11.2 percent of all HLA-A,B,DR-typed potential donors in the NM DP and collected 15.3 percent of all marrows. However, in 1991, the re gional program contained 2.0 percent of HLA-A,B-typed donors and 4.1 p ercent of HLA-A,B,DR-typed donors and collected 5.3 percent of marrows . In 1987, 18 percent of the people who donated marrow at the regional center were phenotypically HLA-A,B,DR identical with the recipient, b ut in 1991, 92 percent Of donor-recipient pairs were phenotypically HL A-A,B,DR identical. Conclusion: Recruitment activities became an incre asingly larger part of the Regional Marrow Donor Program's activities. Increasing the size of the file of potential donors was necessary to maintain a constant number of donations. Persons who were not regular blood donors were an important part of the marrow donor program.