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Japanese Journal of Clinical Oncology 2005 35(11):692-693; doi:10.1093/jjco/hyi186
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© 2005 Foundation for Promotion of Cancer Research

Homepage of the Month

Homepage of the Month

Takahiro Fukuda and Yoichi Takaue

National Cancer Center Hospital, Tokyo, Japan


   Introduction
TOP
 Introduction
TRANSPLANT INDICATIONS, TIMING...
 EXAMPLE OF REFERRAL GUIDELINES...
 
Homepages are redesigned or modified very frequently; therefore, please note that comments in this section are based on the contents of the homepage at the time of writing.



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The National Marrow Donor Program (http://www.marrow.org/)

The National Marrow Donor Program (NMDP) is a non-profit organization based in Minneapolis, MN, USA that facilitates marrow and blood stem cell transplants for patients who do not have a matched donor in their family. This site provides general information on the NMDP and how to become a volunteer donor. It answers the most frequently asked questions of donors, patients and medical professionals, and provides medical information on diseases treatable by marrow or blood stem cell transplantation and the hospitals where transplants are performed.

The NMDP has helped more than 20 000 patients throughout the world who received a transplant for life-threatening diseases such as leukemia and aplastic anemia, as well as certain immune system and genetic disorders. Through its US and International Network, the NMDP manages the world's largest and most diverse registry of volunteer donors, including more than 40 000 cord blood units.

To achieve its mission, the NMDP

  • searches its registry—the largest listing of volunteer donors and cord blood units in the world,
  • supports patients and their doctors throughout the transplant process and
  • matchs patients with the best donor or cord blood unit using innovative science and technology.

To provide resources for transplant patients, the NMDP Office of Patient Advocacy (OPA) can provide

  • one-on-one case management to help patients and their family learn about the unrelated donor search and transplant process,
  • insurance/financial information to help get the answers needed to important insurance coverage questions and
  • additional resources to identify patient-related organizations that can help with other needs such as housing and transportation.
To provide resources for referring physicians, the NMDP physician resource center provides information for physicians who treat patients who may be eligible for hematopoietic cell transplant, and offers practical guidelines on when and how to refer a patient for transplant consultation.


   TRANSPLANT INDICATIONS, TIMING AND REFERRAL
TOP
 Introduction
 TRANSPLANT INDICATIONS, TIMING...
EXAMPLE OF REFERRAL GUIDELINES...
 
When transplant is indicated, the likelihood of a successful transplant can be improved by taking steps to enable the transplantation to be performed at the most beneficial time in the course of the patient's disease. Referral guidelines have been developed jointly by the NMDP and the American Society for Blood and Marrow Transplantation (ASBMT) and are based upon current clinical practice and the medical literature, as well as comprehensive evidence-based reviews. Hematopoietic cell transplantation is a potential lifesaving treatment option for some patients. However, one of the critical factors in improved outcomes is the appropriate timing of the transplant. These guidelines indicate prognostic factors for patients at risk of disease progression using standard therapy and indicate which patients should be evaluated for transplantation. The guidelines provide a basis for initial discussions when developing a treatment plan that may include transplantation.


   EXAMPLE OF REFERRAL GUIDELINES FROM THE NMDP/ASBMT
TOP
 Introduction
 TRANSPLANT INDICATIONS, TIMING...
 EXAMPLE OF REFERRAL GUIDELINES...
 
Acute Myelogenous Leukemia (AML)

  1. (i)High-risk AML including
    1. antecedent hematological disease (e.g. myelodysplasia),
    2. treatment-related leukemia and
    3. induction failure.

  2. CR1 with poor-risk cytogenetics.
  3. CR2 and beyond.

Acute Lymphoblastic Leukemia (ALL)

  1. High-risk ALL including
    1. Poor-risk cytogenetics (e.g. Philadelphia chromosome positive, 11q23),
    2. High WBC (>30 000–50 000) at diagnosis,
    3. CNS or testicular leukemia,
    4. No CR within 4 weeks of initial treatment and
    5. Induction failure.

  2. CR2 and beyond.

Myelodysplastic Syndromes (MDS)

  1. Intermediate-1 (INT-1), intermediate-2 (INT-2) or high IPSS score which includes either
    1. >5% marrow blasts,
    2. other than good risk cytogenetics (good risk includes 5q- or normal) and
    3. >1 lineage cytopenia.

Chronic Myelogenous Leukemia (CML)

  1. No hematologic or minor cytogenetic response 3 months post-imatinib initiation.
  2. No complete cytogenetic response 6–12 months post-imatinib initiation.
  3. Disease progression.
  4. Accelerated phase.
  5. Blast crisis (myeloid or lymphoid).


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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Fukuda, T.
Right arrow Articles by Takaue, Y.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Fukuda, T.
Right arrow Articles by Takaue, Y.
Social Bookmarking
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What's this?