Factors associated with attrition from a national bone marrow registry

Abstract

Summary:During its 10-year existence, the National Marrow Donor Program (NMDP) has been extremely successful at recruiting potential bone marrow donors to join the volunteer registry. Due in part to successful recruitment and the longevity of the registry, the focus of the NMDP has now shifted to decreasing potential attrition when volunteers are recontacted for additional testing to determine whether they would be the optimal donor for a specific patient. Our own interest in the bone marrow donation process led us to examine four domains of variables -demographic characteristics, volunteer history, recruitment-related characteristics and donationrelated concerns -that we hypothesized would be associated with increased likelihood of donor attrition at a key donor decision-point (DR-stage blood typing). Questionnaires were mailed to potential donors after they were contacted at the DR-stage, and had made the decision of whether or not to continue with blood typing. Our final sample included 756 volunteers who decided to continue with typing, and 258 individuals who declined further participation in the registry. In the bivariate analyses, factors in three of the four domains (all except demographic characteristics) were found to be substantially correlated with likelihood of attrition. Logistic regression indicated that nine central variables across the three domains produced the majority of increased attrition likelihood. Finally, a dose-response analysis suggested that as the number of attrition-related factors endorsed by an individual increased, his/her likelihood of dropping out of the registry also increased. Implications for future research and interventions to reduce potential donor attrition are discussed.

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“…[12][13][14][15] However, little data are available in developing countries regarding the efficacy of public education to increase the number of stem cell donors. [16][17][18] University students may play an important role in promoting donation for HSCT because greater knowledge about this procedure in the university population may increase awareness in young people about the need. 11 The purpose of this study was to evaluate the effect of targeted HSCT-related education on knowledge and attitudes in first-year university students in Turkey about HSCT and donation.…”

Non-HLA barriers to unrelated donor stem cell transplantation

“…8,9 The low percentage of searches progressing to transplant through the NMDP, however, suggests that the lack of an available HLA-matched donor may not be the only factor. In this study we focus on other barriers to transplantation.…”

“…Previous research in barriers to stem cell transplantation has focused on the problems of finding an HLAmatched donor and the retention of unrelated volunteers. 8,9 In this study, we address factors other than the lack of an available HLA-matched donor preventing a transplant once a search has been initiated.…”

The importance of identifying a back-up donor for unrelated stem cell transplantation

“…Studies performed on the availability of unrelated donors during confirmatory HLA typing stage have shown the relationship between psychological factors concerning volunteer history, recruitment and donation and the level of attrition. 3,4 Deferral of a chosen donor prior to harvest is less than optimal; without an identified back-up donor, a new search has to be performed which is time consuming and can lead to necessary extra treatment courses and hospital admissions for the patient. Until now no data has been available on the advantage of identifying a back-up donor in the first search for a patient.…”