Promoting Optimisation, Safety, Experience sharing and quality Implementation for Donation Organisation and Networking in Unrelated Haematopoietic Stem Cell Transplantation in Europe
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The project
Introduction
POSEIDON is a project funded by the European Commission (EC), its name actually refers to an acronym which stands for : Promoting Optimisation, Safety, Experience sharing and quality Implementation for Donation Organisation and Networking in Unrelated Haematopoietic Stem Cell Transplantation in Europe. It is a 3-year long project that has officially started the first of June 2007 involving 8 partners from several European countries (the partners) in the intent to improve the safety of Hematopoietic Stem Cells Transplantation and a more egalitarian access to this therapy throughout European Union. This will be done through networking, multidisciplinary experience sharing and education. In order to achieve these goals we will use results from a previous EU project : MADO (The mother project), as well as some other previous works from international or European Non Governmental Organisations (such as the World Marrow Donor Association) and their networks.
A few definitions
Hematopoietic Stem Cell Transplantation :
Medical procedure intended to transplant hematopoietic stem cells harvested from the bone marrow or the blood of a living donor, or from cord blood. Patients requiring a transplantation generally present life-threatening diseases such as leukaemia (cancer of the blood or bone marrow).
The HLA system and histocompatibility :
Human Leukocyte Antigens are several proteins expressed on the surface of all cells which are used as “signposts” by the immune system to distinguish cells of the self from foreign cells. The HLA system, the set of genes coding for the proteins, is highly polymorphic thus providing a unique HLA type for each individual. A cell expresses several HLA on its surface and the likeliness of the combinations influences the compatibility rate (Histocompatibility) between two individuals.
Histocompatibility designates the compatibility rate between a donor and a recipient for organs, tissues or cells. It is based on the human leukocyte antigen system and is an essential factor in the success of a graft.
The project’s objectives
Only a third of patients requiring HSCT have a suitable family donor. In this perspective it is important to provide access to HSCT from unrelated compatible donor pools to the other patients. Currently, the two unique sources of unrelated transplants are registered volunteer donors and banks of Cord Blood Units (CBU).
POSEIDON aims at improving the safety of HSCT and its access in Europe by concentrating on optimising steps prior to the actual donation, namely recruitment of donors, typing strategies and quality, organisation of donor registries/CBU banks, and donor search. The compatibility for the HLA system is crucial and the high polymorphism of this system requires having numerous HLA typed potential donors registered to match patient needs. No country can be self sufficient.
These major objectives should be achieved at the end of the 3 years that will last POSEIDON by carrying out strategic and specific goals. These include :
- The improvement of quality and accuracy of immunogenetic typing.
- The management of specific issues for HSC donation encouragement and for recruitment of donors in minorities.
- The education of relevant health professionals on various aspects of HSCT (technical, ethical, strategic…)
- The relevance of the European dimension for optimal organisation of the stem cell donation health sector.
- The optimal construction of HSC donor Registries based on scientifically and economically validated models.
The overall strategy is to address different aspects of the donation chain, then to integrate them in developing overall recommendations for professionals and policy makers and in organising training of professionals.
Expected results
- Boosting the quality process towards accreditation of HLA laboratories, where needed will generate:
1) increased safety of HSCT through promotion and updating of standards, an external proficiency policy implementation and increased number of accredited HLA laboratories.
2) evaluation of the cost and efforts needed to upgrade for accreditation in the various countries.
3) informed policy to foster accreditation and quality assurance at member state or EU level.
- Improving donor recruitment in national HSC donor registries with specific proposals towards minorities. Cooperation between registries on such recruitment issues is an important strategic expected result in addition to the improved access to HSCT for patients in European minority populations.
- By implementing tools developed by economic analysis and modelling for prospective Registry planning, the project will provide means for planning and measuring the efficiency of registries with homogeneous criteria, for optimal decision on HLA typing level, geographic level of recruitment and optimised balance between registries and cord blood banks use.
- Fostering implementation of best practices in recruitment, typing and management of potential donors through exchanges of experience and training will result in increasing the awareness of professionals involved in HSC donor recruitment and typing and their ability to monitor these activities.
Final Goal
By synthesis and multidisciplinary integration of the results produced in the project, this will lead to:
1) a set of recommendations for recruitment and typing incorporating innovative aspects directed to health professionals and associations involved in the pre-donation chain activities.
2) an information package for policy makers in this domain at national and EU level on available tools and on efficiency of various strategies of recruitment and typing measurement.