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When a child is diagnosed with a serious illness like leukemia, lymphoma, sickle cell disease, or a genetic blood condition, one potential treatment option may be a bone marrow transplant. A bone marrow transplant replaces damaged or diseased bone marrow with healthy cells, helping the body produce new blood and immune cells.
But before a transplant can happen, doctors must find a bone marrow transplant donor whose cells are a close genetic match to the child’s.
What Makes Someone a Perfect Match?
A bone marrow match is based on HLA (human leukocyte antigen) markers. These proteins are found on most cells and are especially important on white blood cells. HLA markers help the immune system distinguish between what belongs in the body and what doesn’t. The closer these HLA markers match between the donor and recipient, the better the chance the new cells will be accepted by the child’s body.
An ideal match occurs when the donor and patient share 10 out of 10 key HLA markers, typically leading to better outcomes and a smoother recovery.
How Are Bone Marrow Matches Determined?
The matching process starts with a simple blood test or cheek swab from the child to determine their HLA type. This is then compared against potential donors, starting with immediate family members.
Haploidentical donors are those who are half or 50% matches. Almost every patient has a haploidentical donor available to them. These include the patient’s biological parents and about 50% of siblings.
The Need for Diverse Donors
HLA types are inherited, so a patient’s best chance of finding a match often lies within their own ethnic or racial group. Unfortunately, diverse populations are underrepresented in national and international donor registries.
While white patients have about a 79% chance of finding a match through the registry, that number drops significantly for:
Hispanic or Latino patients: 48% chanceAsian or Pacific Islander patients: 47% chanceNative American patients: 60% chance
How GCH Research Aims to Fill Donor Gaps
In a clinical trial launched in 2017, the University of Rochester Medical Center and Golisano Children’s Hospital studied the use of haploidentical (half-matched) bone marrow transplants in patients who lacked fully matched donors. “This trial was really successful,” says Dr. Jeffrey Andolina, MD, MS, director of Pediatric Bone Marrow Transplantation and primary investigator of the trial. “We found that both pediatric and adult patients did just as well with haploidentical donors as other patients did with more closely matched HLA unrelated donors.”
By 2021, the practice of conducting bone marrow transplants using haploidentical donors became standard of care in Rochester. “This helps level the playing field for patients of all different races, and we’re especially excited about the potential to help sickle cell disease patients. We continue to see really promising outcomes in our center.”
Pediatric Hematology/Oncology Research at Golisano Children’s Hospital
Our patients have the opportunity to participate in advanced clinical research through the division’s participation in the Children’s Oncology Group. Learn more about our division and active areas of research at Golisano Children’s Hospital.
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