RESEARCH PROPOSAL

Neha Katanguri
Independent Research I GT
2017-2018

How do bone marrow donor types affect a patient’s survival and relapse rate? A
comparison of the most common donor types used in a blood transplant

Overview:

Raising awareness to convince more people to donate their bone marrow cells will help
blood cancer patients. Although there plenty of donor cells in national registries, there are still
many leukemic patients that have to use a different donor type that may lead them to worse
outcomes because of the inability to find a matching, non-relapse associated donor. As a result of
this, leukemia still remains the most common cancer in children, and if communities work
together to donate, a cure may be achieved. With more donor cells in the registries, doctors can
easily find the perfect donor for the patient if an HLA-matching related donor is unavailable.
Additionally, the product created from this research is a brochure that explains the different
donor types, statistics on how donating will help, and ways to donate. It is also a persuasive,
concise brochure that will attempt to bring more attention and get people to donate. If more
organizations contribute to raising awareness so that more people can choose to donate, in future
years leukemic patients will no longer have to worry about having further complications post
transplant. A donor will be available for them when they need it, and this can lead to future
survival and a lower relapse rate.

Background and Rationale:

Children all around the world are diagnosed with a blood cancer almost every day.
Leukemia is one of the most common cancers in children. However, the survival rate is low for
children due to the development stage of their immune system. For most patients, a bone marrow
or blood transplant are the only treatment. However, for a transplant, an HLA-matching donor or
some alleles of mismatching/haploidentical donor type is required for positive outcomes.
According to Dr. ​Morishima’s​ article, mismatching donor cells have higher mortality rates
associated with it, compared with matching donor cells. The main problem is that registries
around the world do not have enough donor options for all leukemic patients. Due to the severity
of the condition, some patients decide on non-HLA matching donors, which can lead to further
complications. If more people donate their blood to bone marrow registries, there will be a wider
range of options for patients to use when considering a donor. Thus, raising more awareness for
this issue will persuade more communities to donate, and provide a future cure for patients with
blood cancers. This is important, because addressing the problem to the society, will allow more
people to get involved and contribute to helping leukemic patients. If people continue to bring
attention, by the next decade, organizations can expand and help leukemia patients overcome
their cancer by providing them with the perfect donor.

Research Methodology and making improvement:

Research Question:​ How can bone marrow donors affect a leukemia patient’s survival and
relapse rate?
Research Thesis:​ The presence of an HLA-matching donor type during a blood transplant will
lead to a higher survival rate and a lower relapse rate.
An HLA-matching donor will lead to better outcomes for the patient, but with the time
constraint, doctors often choose the most available donor. With an expansion of donor types in
registries, this will no longer be a problem if more people donate their stem cells and raise
awareness. This way, doctors can find a donor that leads to a higher survival rate in a short
amount of time. Additionally, some specific mismatching, haploidentical, and cord blood donor
alleles may lead to a lower survival rate.
The design model used for this research was qualitative research. The research is more
descriptive because it compares the different donor types that influence relapse and survival rate.
Rather than using numbers and observations, this research provides reasoning for each of the
claims mentioned. The independent variable includes the different donor types, and the
dependent variable include the effects of the donor types on the survival and relapse rate.

Comparing the factors:

The data collection method used in this research was meta-analysis ​because the valid data
could not be obtained from any of the other options such as observational studies, surveys, etc.
Additionally, there had to be accurate data on experiments that were conducted on patients with
leukemia that had a relapse and the donor type that contributed to their transplant. Through
articles, there was information obtained to support the claims on how the type of donor during a
transplant affects the rate of relapse. This explains that to have the most accurate results on
evidence concerning relapses, meta-analysis had to be used to gather the data. After examining
the four sources picked, the data supported the hypothesis and research. Through the data
collection and analyzing the main donor options, it was discovered which ones were associated
with the highest survival rate and lowest relapse rate.
Although there are other scientific articles on this topic, they generally compare a few
donor types only. This research paper includes and discusses the most commonly used and
considered donor types. This can be helpful for doctors weighing in the effect of relapse and
survival rates on the patient. This paper synthesizes other articles that specifically discuss a
donor type, and compares them all using one main factor. The data collection supports the claim
that HLA-matching donors- regardless of if they are related or unrelated are associated with
better outcomes than with mismatching donors. The literature review supports the evidence
found in the data collection, but uses additional donor types to compare with the donor types
used from the meta-analysis.
The type/allele of a bone marrow donor is extremely essential in determining the success
of the transplant and patient’s prognosis. More people need to contribute to the growing field of
donating stem cells for leukemia patients. This can be achieved by spreading the word and
raising attention to this issue. Most people do not realize they can save a patient’s life by
donating some of their stem cells until they hear about it. ​The product will bring more awareness
to people to take further measures. If more people understand the difficulty in finding the perfect
matching donor due to the factors associated with it, some people may be willing to donate.

Product Objectives:

From the research conducted, a brochure placed in a doctor’s office will bring more
attention to parents and other patients sitting in the waiting room. The brochure will include the
various donor types and how the different alleles affect the relapse and survival rate. From this,
the audience can realize that leukemic patients require a donor that matches their stem cells, and
this can be achieved if more people donate. Patients waiting can browse through the brochure
which will include important details about the process of donating and raising more awareness
for a significant cause. The brochure option was mainly chosen because it is the most reliable
product that will catch the audience’s attention and provide specific details in an organized
method. Additionally, if it is placed in a community center or doctor’s office, people can read it
and keep it with them, so it can be easily communicated.
The audience of the project is for scientists and doctors to analyze the most common
donor types in one condensed paper. The audience of the product is generally people in
communities and specifically minorities (more stem cells from minorities are needed more than
any other ethnicity). Patients and doctors can benefit from this project because with raising
awareness, more donor cells will be in the bone marrow registries, and leukemic patients will
have more hope in a recovery without relapse. The product is intended to long-term help increase
the survival rate for leukemic patients, without causing further complications in their health.
Since leukemia is one of the most common cancers in children, this can help them find hope that
there are plenty of donor cells available for their transplant. An outlet vehicle that can be used to
bring more attention is a presentation at community meetings or colleges. If more young adults
contribute to this, there will be more new, healthy cells in the registries. Additionally, a YouTube
video can be made by including the statistics and issue to resolve.

Logistical Considerations:
 Since the product is a brochure, paper and money is required. According to GotPrint.com,
100 brochures that are 8.5 x 11 inch tri-folds are about $68.45. Printing, distributing, and
transportation in doctor’s offices or community centers is needed. Additionally, permission is
required from the doctor and/or the manager of the community center to have the brochures
distributed. A timeline will be added that outlines the data collection, product development, and
audience distribution.

Approval:

___________________________ ___________________________
Student Signature Mentor/Advisor Signature

_____________________
G/T Resource Teacher Signature
References:

GotPrint. (n.d.). Retrieved April 11, 2018, from

http://www.gotprint.com/content.html?id=landingPages_mP_brochures-0_001&leftMenuHide=t
rue&gclid=EAIaIQobChMI35bDivKw2gIVE4_ICh13uQQBEAAYAiAAEgJtNvD_BwE

Morishima, Y., Kashiwase, K., Matsuo, K., Azuma, F., Morishima, S., Onizuka, M., . . .
Sasazuki, T. (2015, February 12). Biological significance of HLA locus matching in unrelated
donor bone marrow transplantation. Retrieved March 11, 2018, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326776/