Mission statement:

The mission of the Clinical Working Group (CLWG) is to be the international resource for donor centers, donor registries, cord blood banks, transplant centers and the public on all clinical matters pertaining to the donation, donor safety, transportation and infusion of hematopoietic stem and progenitor cells for transplantation.

Projects:

• Review donor eligiblity criteria - see paper that is under review
• Review statement on donor consent form - see information
• Donor follow upDonor Follow Up

Interesting publications:

• Study in New England Journal of Medicine compares outcomes between unrelated bone marrow and peripheral blood transplants (press release NMDP) with link to article

Recommendations of the Clinical Working Group (CLWG):

BIOSIMILARS:

Concerns about the use of Biosimilar Granulocyte Colony Stimulating Factors for the mobilization of stem cells in normal donors.

Recombinant Granulocyte Colony Stimulating Factor (G-CSF) is routinely used for the mobilisation of haematopoietic stem cells (HSC) from the bone marrow into peripheral blood for collection by apheresis for transplantation. Since the late 1990s, HSC collection from related and unrelated healthy donors has been routine in Europe and North America. Two branded forms of G-CSF have been marketed since the early 1990s and there is extensive data concerning their use in normal donors.

Since 2002, the World Marrow Donor Association (WMDA) has maintained a centralised database collecting both short and long-term adverse events in unrelated donors receiving G-CSF. Recently, G-CSF biosimilar agents have become available. Biosimilars can be licensed based on data showing comparability to the reference product for the primary indication. Here we present the available evidence for the licensing of biosimilar G-CSF for mobilisation of HSC in Europe. As the efficacy for mobilisation is extrapolated, with little safety analysis and no long-term follow-up, the WMDA recommends that biosimilars must not be used for mobilisation in normal donors unless the donor is followed on a study addressing this question. Only when comprehensive data to confirm safety and efficacy is available should use of G-CSF biosimilars be considered routine. More information about this can be found by clicking on the following links:

• Position Statement of the WMDA
• Publication of the WMDA in Haematologica
• Publication in Haematologica of the Italian Group
• Publication in European Journal of Haematology
• Letter of the EBMT (January 2009)

SUBSEQUENT DONATIONS

Unrelated donor SCT activity is increasing, and in 5–10% of cases a subsequent donation of stem cells or donor lymphocytes may be requested. Second donations of stem cells are not associated with an increased chance of donor complications, but the yield of CD34+ cells may be lower in some donors. It is acceptable practice for any registry to request subsequent donations and it is recommended that donors should be counselled about this possibility before their first donation. Guidance is provided on the requirements for further medical assessment, the procedures used to agree requests, frequency and timing of donation and timing and duration of donor follow up. Read more...

UNRELATED HEMATOPOIETIC STEM CELL DONORS AS RESEARCH SUBJECTS.

Research involving human subjects is critical to improving outcomes for recipients of HSCT and for improving the donation process for unrelated stem cell donors. WMDA calls on Registries to actively participate in research activities aimed at improving clinical outcome. Most HSCT today takes place under some research transplant protocol, but in the majority of these protocols the donor will not be regarded as a research subject. However, there will be instances where a donor is a research subject. Therefore, WMDA recommends that individual registries establish procedures for efficient handling of such kinds of donation requests to support worldwide research activities and to ensure timely donation of high-quality hematopoietic stem cells for all patients in need of an unrelated donor. Read more..

• Special Report in BMT: Donor as research subject
• Commentary on the special report by F. R. Appelbaum
• Commentary on the special report by J.F. Apperley
• Commentary on the special report by C. Craddock
• Letter from the WMDA to the editor

MINIMUM CRITERIA FOR A SPECIFIC DONOR TO BE AVAILABLE FOR A PATIENT 

• Recommendation
• Survey

Projects reported:

• White paper on donor safety
• Donor remenuration
• Family donor care management
• Review statement on donor consent form - see information

Presentations: slides of the CLWG meeting Minneapolis 2012

Minutes: link to the minutes of the previous meetings (only for WMDA members) 

Chair: Bronwen Shaw, United Kingdom

Vice-chair: Jeff Szer, Australia