Michele L. Donato, MD, medical director, Blood and Marrow Collection Facility, John Theurer Cancer Center (JTCC), provides an overview of the National Marrow Donor Program (NMDP).

The NMDP helps to find donors for anyone in the world that may need a transplant. Internationally, about 20 million donors have signed up. At JTCC, if a patient requires a bone marrow transplant, the NMDP is contacted, and access is granted to the marrow bank. It takes an average of 49 days to find a donor through this program, Donato says, and it is more difficult for minority patients. JTCC also collects for the NMDP.

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Dr. Donato Discusses the National Marrow Donor Program

Michele L. Donato, MD, medical director, Blood and Marrow Collection Facility, John Theurer Cancer Center, discusses advances in the prevention of graft-versus-host disease (GVHD).

It is clear now that younger donors perform better: They experience less GVHD, better disease control, and fewer treatment-related complications. Donor selection is crucial in the prevention of GVHD, Donato says, and physicians now have the capacity to select donors where the indigence of GVHD will be less.

GVHD is of particular concern in haploidentical and half-match transplants, but the process of giving post-transplant, high-dose cyclophosphamide to kill activated T cells has been effective in this space. This process has made it possible to do haploidentical and half-match transplants with no more â€‹GVHD than in a fully-matched sibling and has also been looked at in unrelated donors.

Dr. Donato on Advances in the Prevention of GVHD

Michele L. Donato, MD, medical director, Blood and Marrow Collection Facility, John Theurer Cancer Center, discusses emerging trends in bone marrow and stem cell transplantation.

Donato says one emerging trend in transplantation is using the graft for immunotherapy. More transplants using haploidentical donors are being conducted because physicians know that they can immunologically predict which donor would be preferable in terms of disease control, infection prevention, and graft-versus-host disease prevention. Physicians and researchers are continuing to work on how to best select donors, Donato says.

Another emerging trend in transplantation is the manipulation of the graft to get a better graft-versus-tumor effect. Donato believes this will be a trend for the future of transplantation.

Michele L. Donato, MD

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Dr. Donato Discusses the National Marrow Donor Program

Dr. Donato on Advances in the Prevention of GVHD

Dr. Donato on Trends in Blood and Marrow Transplantation