	Background

Most of the diseases treated by stem cell transplantation involve  abnormalities of the blood, metabolic, or immune systems. Bone Marrow and Other Sources of Stem Cells for Transplantation

Although bone marrow was initially the only source of stem cells for  transplantation, in recent years two other sources of stem cells, umbilical  cord blood and peripheral blood stem cells (PBSC), have also been used. A donor, matched to a patient, may be asked to donate either  bone marrow or PBSC, depending on the preference of the patient’s  physician. These other registries, however, are relatively small;  often specialize in donors from particular racial or ethnic groups; and are  private, with no national requirements. National Registry May Be Underutilized

Although the exact number of patients in need of transplants from  unrelated donors is not known, the number of patients utilizing the  Registry to search for matches is about one-third of the estimated number  of patients in need of unrelated donor transplants. This suggests that the Registry may be underutilized, as many  more U.S. patients may need unrelated donor transplants than obtain them  through the Registry. The results of the selected site visits, analysis of CPI measures, and  incident report summaries we reviewed show that the organizations in the  NMDP network generally adhere to NMDP’s standards and procedures. In 2001, NMDP  required 24 donor and transplant centers to take corrective actions  because they did not meet its standards.
What GAO Found

More than 30,000 people are diagnosed annually with leukemia or other blood, metabolic, or immune system disorders, many of whom may die without stem cell transplants, using stem cells from bone marrow or another source. When a patient needs a transplant of donated stem cells and no genetically compatible related donor is available, the National Bone Marrow Donor Registry may help the patient search for compatible stem cells from unrelated donors. The National Bone Marrow Registry Reauthorization Act of 1998 required, among other things, that the Registry carry out a donor recruitment program giving priority to minority and underrepresented donor populations, ensure efficiency of operations, and verify compliance with standards by organizations that participate in the Registry. From 1998, when the National Bone Marrow Registry Reauthorization Act was enacted, through 2001, the number of stem cell donors on the Registry increased for all racial and ethnic groups. Although the exact number of patients in need of transplants is not known, estimates suggest that about one-third of them use the Registry to search for donors. The organizations that are involved in transplantation and participate in the National Marrow Donor Program (NMDP) network generally adhere to NMDP's standards and procedures. In 2001, NMDP required 24 centers to take corrective actions because they did not meet its standards.