If your child needs stem cells from someone else, we will determine the best donor possible using HLA typing. HLA typing is the process of determining each person's transplant antigens. Antigens are "fingerprints" on the surface of almost all cells of the body.The typing process has two steps. The first is called serological typing, which provides a broad definition of your tissue type. The second step, which is more refined and specific, is performed using a DNA method. Although no two people have exactly the same antigens on all of their cells (except for identical twins), it is helpful to find a donor whose HLA type is as similar as possible to the patient's HLA type. We will begin by drawing blood from and HLA typing the patient and the immediate family members.
Approximately 25 out of 100 patients have a family member who is a match at the six major sites tested. If a family member matches in five or six of the areas, he or she may be selected as a donor. If more than one family member matches, our transplant specialists will choose the most appropriate donor using blood tests and clinical information.
If no acceptable match is found within the family, the transplant team may conduct a preliminary search for an unrelated donor through the National Marrow Donor Program (NMDP) and more than 46 international and cord bank computerized database registries. The preliminary search is free.
The transplant team will ask the registries to contact potential matched donors for further testing. This is a formal search and this requires insurance coverage or a financial down-payment. The transplant team meets at least weekly to review the status of the donor search, and the Stem Cell Transplant Patient Coordinator will update the patient and family on a regular basis.
Some patients will not have an acceptable donor in the registries. There are research studies where family members may be used as a donor even if they are not a close enough match for a traditional transplant. This type of transplant is called a haploidentical transplant.Any family member between the ages of 17 and 60 who has been HLA tested at Dana-Farber Cancer Institute may enroll in the NMDP by contacting the NMDP Donor Center at 617-632-2561. All family and friends also are encouraged to consider enrolling in the Platelet Pheresis Program at Dana-Farber, Boston Children's Hospital or another cancer center. This program will enroll individuals into the NMDP free of charge after donating platelets three times.