Abstract 20: National Cord Blood Network Training Tool to Optimize Cord Blood Unit (CBU) Selection

Abstract Introduction Transplant Center (TC) proficiency and comfort with CBU search and graft selection is an ongoing challenge despite evidence-based ASTCT CBU selection guidelines (Politikos et al, BBMT 2020). This can compromise utilization of CB as a stem cell source. Objectives To optimize searches and high-quality graft selection, the National Cord Blood Network created a comprehensive training module with stepwise instructions for CBU search, selection and graft acquisition using the ASTCT guidelines and NMDP’s MatchSource® application. This module will be shared with Network members in webinar format and can be utilized for individualized search coordinator training. Methods Experienced search coordinators transformed the ASTCT guideline into a user-friendly step-wise guide of the CBU search process incorporating MatchSource® functions (e.g., Antibody Specificity Risk Assessment; Allele Reveal) and adding diagrams, screenshots, prompts, and helpful tips. The approach of creating a customized list of potential units for each patient is demonstrated including how CBU not meeting pre-determined quality criteria can be “filtered-out”. Experienced CB physicians provided concise graft selection recommendations for various patient groups (e.g., high-risk leukemias, non-malignant diseases, very urgent transplants) consistent with national guidelines. Results To maximize efficiency, we divided the process as follows: • Search Coordinator Review: systematic collection of all suitable CBU in MatchSource®, after setting lower limits for TNC/CD34 cell doses, HLA-allele level match, cryopreservation volume and year of collection; • CB Physician Review: a shorter list of CBU that meet pre-determined quality criteria, including information on HLA-allele mismatches, Donor Specific Antibodies, licensure, Bank of origin and previously performed confirmatory HLA typing; • Final Graft and Back-up Selection: graft decision after reviewing the detailed characteristics of the final potential CBU list. Discussion This tool aids the selection of high-quality CB grafts and thereby could facilitate improved CB transplant outcomes. Our next step is to create a consortium of Network search coordinators and disseminate the tool nationally. Additionally, to assess the benefits of training for coordinators without extensive experience, metrics on search efficiency and “ease” of graft selection will be evaluated.