a05b2513042ae84721fa2a8a6e9c1151.ppt
- Количество слайдов: 24
STEM CELL DONOR REGISTRIES A. Vanhonsebrouck, MD E. Baudoux, MD ARMB-KAGB 25/04/2012 1
EBMT Annual report, 2010 Hematopoietic stem cell transplantation (HSCT) has become an accepted therapy for many congenital or acquired disorders of the hematopoietic system and has seen major changes in indications and use of transplant techniques over the years. ARMB-KAGB 25/04/2012 2
Principle Bone Marrow Blood WBC RBC Platelets ARMB-KAGB 25/04/2012 3
Stem cell sources PBSC ARMB-KAGB BM CB 25/04/2012 4
Brief History Decade Event 1950 Survival of irradiated animals after letal irradiation+infusion BM First attempts humans : treatment of hematological diseases (Mathé-France, Donnall Thomas-USA) 1960 Failure of BM transplantation due to severe adverse reactions 1970 First studies of BM transplantations in leukemic patients with HLA matched Donors Hematopoietic progenitors in Cord Blood (CB) First BM Donor Registries 1980 1990 Nobel Prize for the HLA system: Jean Dausset (France) First CB transplantation: E. Gluckman (France) Development of BM Donor Registries Nobel Prize for transplantation of organs/ cells: D. Thomas (USA) Considerable growth of BM Donor Registries and CB Banks 2000 Steep increase in use of unrelated donor stem cells (CB-donors) 2010 19 Million donors available -0. 5 Million CBU ARMB-KAGB 25/04/2012 5
Human Leucocyte Antigens Father Mother Children ARMB-KAGB 25/04/2012 6
Donors –CBU worldwide BMDW: 19 Million BMDW: 0, 5 Million BMDW : Bone Marrow Donors Worldwide WMDA : World Marrow Donor Association ARMB-KAGB 25/04/2012 7
MDPB-REGISTRY (Marrow Donor Program Belgium) • HISTORY : 1989 Belgian Stem Cell Donor Registry • ADDRESS : MOTSTRAAT 40, 2800 MECHELEN • COMPOSITION MDPB-REGISTRY TASK: FINANCIAL – ADMINISTRATIVE MANAGEMENT STAFF: DIRECTOR: A. VANHONSEBROUCK Adjunct Director + 2 Search coordinators MDPB-VZW/ASBL TASK: MEDICAL AND SCIENTIFIC ADVISE PRESIDENT : E. BAUDOUX Representatives of Transplant Center (TC), Donor Center (DC), Cord Blood Bank (CBB) and Collection Center (CC). ARMB-KAGB 25/04/2012 8
MDPB-REGISTRY Goals • To provide stem cells from an HLA identical unrelated donor to national/international patients • Stem cell transplantation for patients with hematological diseases (malignant and non-malignant) o Related : familial transplantation: 1/4 perfect match o Unrelated : 1/50. 000 perfect match • National Collaboration o 9 donor centers/ 10 transplant centers/ 5 cord blood banks/ 5 collection centers • Part of international collaboration o BMDW : 19 million donors – 500. 000 CBU o Cooperation with 65 stem cell donor Registries – 44 Cord Blood Banks ARMB-KAGB 25/04/2012 9
MDPB-REGISTRY Internet 7 donor centers >60 000 Donors Internet 5 Cord blood banks >16 000 CBUs Searching for national donors Internet 9 Transplant centers (national patients) 2011 MDP-B Registry (Syrenad) Unrelated donors Belgian Patients EMDIS 44 CB BANKS >18 M DONORS ARMB-KAGB 65 INTERNATIONAL REGISTRIES Searching for International donors >500 000 CBUS 25/04/2012 11
MDPB-R Donor inventory N = 60346 Donors ARMB-KAGB 25/04/2012 12
MDPB-R Cord blood inventory N=16088 CBU ARMB-KAGB 25/04/2012 13
MDPB-R Search-Transplant activity BELGIAN PATIENTS ARMB-KAGB 25/04/2012 14
MDPB-R Transplant activity ARMB-KAGB 25/04/2012 15
MDPB-R Transplant activity ARMB-KAGB 25/04/2012 16
MDPB-R SWOT analysis STRENGHTS • WELL-INTEGRATED NETWORK between partners ( DC, CBB, TC, Col. C, HLA lab) • Connected to REGISTRIES WORLDWIDE • ACTIVE participation with INTERNATIONAL GROUPS (WMDA, Netcord) OPPORTUNITIES • ACCREDITATION • Investment in NEW DATA EXCHANGE TOOLS • INCREASE INTERNATIONAL COOPERATION • NEW RECRUITMENT STRATEGIES (fe minorities) • CONTINUOUS RECRUITMENT ACTION ARMB-KAGB WEAKNESSES • SIZE (international context) • LOW INSTITUTIONAL support • MOST DONORS ARE FROM ABROAD (for transplantations of Belgian Patients) • Potential solutions reachable • Cancer plan • Official mandate to operate THREATS • AGE/ HLA TYPING level of donor population • BIGGER transnational structures with ample funding • MORE BELGIAN STEM CELL DONORS (for Belgian-international Patients) 25/04/2012 17
MDPB-R PROJECTS 1. Donor Recruitment Action Plan SITUATION before 2008 - number of donors : 45. 000 - donor data base is aging (drop-off >60 y) - data HLA typing is poor/ median age: 45 -50 y CONTRACT with RIZIV-INAMI - 5 years (2008 -2013) : 10. 000 new donors - HLA typing better quality : molecular methods (A, B, C, DR) - Recruitment campaigns donor centers and transfusion centers ACTUAL RESULTS -SUCCESS ! Total amount : 60346 new donors 12. 627 CHALLENGE : CONTINUOUS RECRUITMENT AFTER 2013 ARMB-KAGB 25/04/2012 18
Donor Recruitment action Plan ARMB-KAGB 25/04/2012 19
MDPP-R PROJECTS 1. Donor Recruitment Action Plan ARMB-KAGB RKVL : ANT+BTO SJB : St Jan Bruges VUB : UZ Brussel GOD : Mont Godinne SFS : Service du Sang KUL : UZ Leuven 25/04/2012 20
MDPB-R PROJECTS 2. CANCER PLAN - CANCERPLAN launched in 2008 – actions were defined - STRUCTURAL SUPPORT OF TISSUE BANKS FOR CELL THERAPY and THERAPY with HSC and CB by financing (personnell – storage – general costs) 13 hospitals receive funding - MEETING MDPB-R and delegates of CANCER CENTRE 2011 NEW PROPOSALS – EVALUTION FOLLOWS Optimizing test capacity of TISSUE TYPING LABORATORIES RECRUITMENT CAMPAIGNS to sensitize stem cell donors Improve the POSITION of the stem cell donor COOPERATION between MDPB-R, MDPB-vzw and BHS Financing the TRANSPLANT REGISTRY: central database with followup of patients ARMB-KAGB 25/04/2012 21
MDPB-R PROJECTS 3. IT APPLICATION -January 2008 : Software SYRENAD (FGM - France) webbased application for exchange of information between centers (Donor Centre, TC, CBB, Collection Centers) and Registries -EMDIS (European Marrow Donor Information System) (15 countries) electronic communication between MDPB/intern. Registries encrypted secured email based communication system -PROMETHEUS : FUTURE SOFTWARE APPLICATION already used in more than 10 registries EMDIS : connection with 27 countries ARMB-KAGB 25/04/2012 22
IT application – Syrenad -Prometheus Global search: 28 Emdis connections Canada US NMDP US Caitlin Finland Denmark Czech (Plzen) BBMR Slovakia Poland Cyprus Israel EUROPE : Germany, Switzerland, Spain, France, Italy, Netherlands, UK-Wales, Austria, Sweden, Norway, Czech R. South Africa SYRENAD: 15 Taiwan Australia PROMETHEUS : + 12 EMDIS connections ARMB-KAGB 25/04/2012 23
4. MEDIUM SIZED REGISTRIES -Medium Sized Registries : 20. 000 -100. 000 donors -countries : Switzerland, Belgium, Sweden, Spain, Cyprus, Norway, Finland, Czech Republic, Ireland, Wales, Austria, Netherlands, Denmark -First meeting sept 28, 2011 -Purpose : maintain and strengthen viability of « medium sized » registries by increasing efficiency and diversity in a situation with enhanced needs and limited resources ACTION PLAN : PHASE II Improve recruitment of suitable donors IT Indicators for benchmarking EU application HLA typing, strategy, efficiency Quality Management Refining CT work up HLA expertise Regulatory Issues ARMB-KAGB 25/04/2012 24
THANK YOU ! MORE INFO Annual report 2011 will be available on the website www. infodonor. be end of June 2012 ARMB-KAGB 25/04/2012 25
a05b2513042ae84721fa2a8a6e9c1151.ppt