New Zealand Bone Marrow Donor Registry

Transcription

1 Title: Authorised by: SECTION 9.0 NZBMDR STANDARDS PROCESS FOR AN UNRELATED STEM CELL DONOR WORKUP & IDENTIFICATION OF CORD BLOOD UNITS Executive Officer Contributing Authors: Sally Gordon Dr Hilary Blacklock Raewyn Fisher NZBMDR-Guidelines Date Effective 23/1/2014 Page 1

2 Table of Contents SECTION 9.0 NZBMDR STANDARDS PROCESS FOR AN UNRELATED STEM CELL DONOR WORKUP & IDENTIFICATION OF CORD BLOOD Introduction - Release of NZBMDR... 3 Table 16 New Zealand Patient - New Zealand... 4 Table 17 New Zealand Patient - ABMDR donor..5 Table 18 New Zealand Patient - International... 6 Table 19 International Patient - New Zealand... 7 Table 20 New Zealand Patient - Cord Blood Unit... 7 NZBMDR-Guidelines Date Effective 23/1/2014 Page 2

3 CRITERIA FOR RELEASE OF NZBMDR DONORS Collection of stem cells from an NZBMDR donor will be approved under criteria listed in the publication Indications for Haematopoietic Stem Cell Transplantation compiled by the Bone Marrow Transplant Study Group of the Haematology Society of Australia and New Zealand and the EBMT special report of Allogeneic and autologous transplantation for haematological diseases, solid tumours and immune disorders : definitions and current practice in Europe. If a Transplant is considered Non-standard, High Risk or Experimental under these criteria the collection must be approved by the Scientific Advisory Committee. If the collection is approved the donor must be informed of the committees reasoning before deciding whether to proceed with donating stem cells. NZBMDR will release donors to Transplant Centres searched by Registries participating on BMDW. Other Transplant Centres, not associated with BMDW are required to forward credentials which will be considered by the Scientific Advisory Committee before a donor will be released. NZBMDR allows a one antigen mismatch of HLA A, B, DRB1* between patient and donor. NZBMDR-Guidelines Date Effective 23/1/2014 Page 3

4 9.1 PROCESS FOR UNRELATED STEM CELL DONOR WORKUP FOR NEW ZEALAND PATIENT - USING A NZ DONOR Suitable New Zealand donor selected by Transplant Centre in consultation with Tissue typing Lab. Trans[plant Centre contacts NZBMDR with tentative transplant date, Forms MC001, GC001/MC003, 22VT & TT report to accompany this request. entered into Matchpoint NZBMDR ascertains donor availability Transplant date confirmed by mutual agreement between, Collection and Transplant Centres via NZBMDR NZBMDR refers donor to third party physician for counseling, physical exam & assessment of fitness to donate Form 43 & 50 [within 30 days of transplant date] Intent to Donate signed (Intent Form B) Letter to donor s GP re medical results and intent to donate Form WU 01 sent to TX centre permanently temporarily NZBMDR releases donor clearance to Transplant Centre Verification of HSC collection & Form WU 02 sent to TC centre Third party physician in consultation with Medical Officer and GP to arrange s further testing &/or treatment if required Decision Re courier of HSC made by Transplant Centre and NZBMDR. Section 14 HSC Couriers See Section 11.0 Guidelines for Collection of Marrow Form 60 & 61 or G60 to be completed at HSC collection Table 16 See Section 13.0 Retirement and Follow-Up NZBMDR-Guidelines Date Effective 23/1/2014 Page 4

5 9.2 PROCESS FOR UNRELATED STEM CELL DONOR WORKUP FOR NEW ZEALAND PATIENT - USING AN AUSTRALIAN DONOR Suitable ABMDR donor selected by Transplant Centre (TC) in consultation with Tissue Typing Lab. NZBMDR contacts ABMDR National Office with request for donor with tentative transplant date. Prescription for Marrow or Peripheral Blood Stem Cells (PBSCs), Form 22CT, TT report to accompany this request. entered into Matchpoint Clearance Forms Required: Form 43 Form 50 Form B or Form GB (Intent to Donate) ABMDR ascertains donor availability and refers donor to third party physician within 30 days of transplant date for counselling, physical exam & assessment of fitness to donate. Appropriate donor clearance forms provided to TC in a timely fashion. request to DC via Matchpoint Transplant date confirmed by mutual agreement between /Collection/Apheresis Centres and Transplant Centre via NZBMDR/ABMDR permanently TX cancelled temporarily TX cancelled or ABMDR releases donor details to Transplant Centre via NZBMDR. Verification of HSC Form signed Decision re transport of HSC made by Transplant Centre. and NZBMDR Refer Section 14 Couriers Collection report completed by collection centre to accompany HPC Patient follow up Form PP1 Table 17 NZBMDR-Guidelines Date Effective 23/1/2014 Page 5

6 9.3 PROCESS FOR UNRELATED STEM CELL DONOR WORKUP FOR A NEW ZEALAND PATIENT - USING AN INTERNATIONAL DONOR Suitable donor selected by Transplant Centre in consultation with Tissue Typing lab. Transplant Centre contacts NZBMDR National Office with Prescription for Marrow or PBSC and other documentation relevant to individual registries. Tentative Transplant dates to be included. NZBMDR forwards all documents to International HUB Centre International Registry ascertains donor availability and suitability to donate Transplant date confirmed by Centre Workup unlikely to proceed International Registry releases donor details to Transplant Centre via NZBMDR Verification of HPC completed Decision re transport of HSCs made by Transplant Centre and NZBMDR See Guidelines for NZBMDR HSC Couriers (Section 14.0) Table 18 Patient Follow Up Form PP1 and Termination of Search (Form 115) NZBMDR-Guidelines Date Effective 23/1/2014 Page 6

7 INTERNATIONAL PATIENT - USING A NEW ZEALAND DONOR Suitable NZBMDR donor selected by transplant centre International Registry contacts NZ/ABMDR National Office with written request for donor and tentative transplant date (Prescription for HSC, Patient and donor confirmatory typing required) NZBMDR ascertains donor availability and refers donor to third party physician for counselling, physical exam & assessment of fitness to donate [within 30 days of transplant date] (Form 43 & 50) Intent to Donate signed (Intent Form B) Letter to donor s GP re medical results and intent to donate. WU 01 sent to International HUB Transplant date confirmed by mutual agreement between, Collection Centre and Transplant Centre via NZBMDR & International Registry permanently Third party physician in consultation with Medical Officer and GP to arrange s further testing &/or treatment if required temporarily NZBMDR releases donor details to Transplant Centre Form 43 and 50 Verification of HSC and WU 02 form completed Decision re courier made by Transplant Centre See Section 11.0or 12 Guidelines for Collection of HSC Form 60 & 61 or G60 to be completed at HSC collection Table 19 See Section 13.0 Retirement and follow-up NZBMDR-Guidelines Date Effective 23/1/2014 Page 7

8 9.5 PROCESS FOR PROCUREMENT OF CORD BLOOD FOR A NEW ZEALAND PATIENT - USING AN INTERNATIONAL CORD BLOOD UNIT Preliminary search sent to Cord Blood bank or International Hub following BMDW search Report with unit details including cell counts requested Extended or confirmatory typing requested Suitable Cord Blood unit selected by Transplant Centre in consultation with Tissue Typing Lab. NZBMDR contacts Cord Blood Bank or International HUB with written request for cord blood unit Including proposed shipping & transplant date Documentation relevant to individual registries will be required Request Cancelled Australian units collected by NZBMDR personal courier. Other International units transported by World Courier NZBMDR-Guidelines Date Effective 23/1/2014 Page 8