Once the patient’s physician has determined that an allogeneic bone marrow or blood stem cell transplant is the best course of treatment, a suitably matched donor must be identified. This is a multi-step process including immediate and extended family studies and an international unrelated donor search. Patients are encouraged to test immediate family members first. However, frequently time is a patient’s biggest enemy. Thus, if a sibling match is not identified immediately, it is worthwhile to initiate an unrelated donor search concurrently with an extended family study.

PATIENT ADVOCACY
It is important that patients maintain regular contact with the transplant center in order to obtain regular updates on the status of the donor search. If they are unable to perform this task, they are entitled to designate an advocate of their choosing, usually a close relative or friend to interface with the transplant center on their behalf.

IMMEDIATE FAMILY STUDY
Logic dictates that the most suitable match for a patient would be a family member.

1. There is a 25 percent chance that a sibling will be a match. If the sibling is an identical twin, there will be a perfect match, referred to as syngeneic.
2. Parents share 3 of 6 antigens with their biological children. This is referred to as haploidentical. In some cases, parents will share antigens in common with each other. In these circumstances, patients may share more that 3 of 6 antigens with a parent.