The National Marrow Donor Program (NMDP), also known as Be The Match, is a non-profit organization established in 1987. Its mission is to save lives by providing cellular therapy, offering hope to those with serious blood disorders. The program adopted the name NMDP in early 2024 to reflect its modernized brand.
Core Function and Purpose
The primary goal of NMDP/Be The Match is to facilitate life-saving transplants for patients with various blood cancers and severe blood diseases. These include leukemias, lymphomas, aplastic anemia, sickle cell disease, and specific immune-deficiency disorders, among over 75 conditions treatable by blood stem cell transplants. The program coordinates two main types: bone marrow donation, which collects blood-forming cells directly from the bone marrow, and peripheral blood stem cell (PBSC) donation, which collects cells from circulating blood. NMDP manages a global network, including the world’s most diverse registry of potential donors and cord blood units. This network allows doctors worldwide to search for unrelated donors when a matched family member is unavailable, which occurs for approximately 70% of patients.
The Donor Matching Process
Matching a donor and patient for a blood stem cell transplant relies on Human Leukocyte Antigen (HLA) typing. HLA proteins are markers on most cells that the immune system uses to distinguish between the body’s own cells and foreign invaders. A closer HLA match significantly reduces the risk of complications like graft-versus-host disease, where donor immune cells attack the patient’s body. Six HLA molecules are evaluated for a match: HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1.
Genetic diversity within the donor registry is important for finding suitable matches, especially for patients from diverse ethnic backgrounds. Because HLA markers are inherited, patients are more likely to match someone with a similar racial or ethnic heritage. If a potential match is identified, the individual is contacted to confirm their willingness to proceed. Subsequent steps involve additional blood tests and a health questionnaire to ensure the donor’s health and the best possible outcome for the patient.
Becoming a Donor
Individuals interested in joining the Be The Match Registry can start by completing a cheek swab kit for HLA typing. Eligibility requires donors to be between 18 and 60 years old, meeting specific health guidelines. Donors aged 18 to 35 are preferred, as research indicates they provide the greatest chance for transplant success. The program covers all medical and travel costs associated with donation.
There are two primary methods: peripheral blood stem cell (PBSC) donation and bone marrow donation. PBSC donation, accounting for about 90% of all donations, is a non-surgical procedure. Donors receive daily injections of filgrastim for five days, which increases blood-forming cells in their bloodstream. These cells are then collected through apheresis, where blood is drawn from one arm, passed through a machine to separate stem cells, and the remaining blood is returned to the other arm.
Bone marrow donation is a surgical procedure performed under anesthesia. Liquid marrow is withdrawn from the back of the pelvic bone using needles.
PBSC donors may experience headaches or bone and muscle pain similar to flu symptoms from filgrastim injections, which disappear shortly after donation. Marrow donors may experience back or hip pain, fatigue, and bruising at the incision site. Recovery for marrow donation usually takes a few weeks, with the body regenerating marrow within about six weeks. Serious side effects from either method are uncommon, occurring in less than one percent of PBSC donors.
Impact and Significance
The NMDP/Be The Match has significantly impacted patients’ lives and the medical community by providing cellular therapies. Since its founding in 1987, the program has facilitated over 140,000 transplants for individuals facing life-threatening blood cancers and disorders. Its global registry provides patients access to over 42 million potential donors worldwide, significantly increasing the chances of finding a compatible match. Despite these successes, the need for more registered donors persists, as approximately 70% of patients lack a fully matched donor within their family. NMDP actively supports patients and their families throughout the transplant journey, beyond just finding a match. This support includes patient assistance programs, which provided over $6.6 million in 2024, and ongoing research initiatives with approximately 200 studies and clinical trials aimed at improving transplant outcomes and finding new treatments.