A research leader in the Department of Defense Marrow Donor Department (C.W. Bill Young Marrow Donor Recruitment and Research Directorate), the Bone Marrow Research Directorate provides military contingency support for casualties with marrow toxic injury due to radiation or chemical warfare agents. The directorate performs laboratory research that supports technology innovations to make highly reliable and cost-effective DNA-based typing for marrow transplants.
NMRC's C. W. Bill Young Marrow Donor Program (BYMDP) is a prime example of the Navy's innovative research and how it has far-reaching effects. What started as basic research to explore the idea of viable versus non-viable organ transplants has spawned a national registry of bone marrow donor candidates, giving the gift of life to service members and civilians.
Exposure to radiation and chemical agents (such as nerve and mustard gases) used in modern warfare can cause unrecoverable damage to bone marrow (the blood-forming organ), breaking down the immune system in the process.
The idea of transplanting a viable organ like bone marrow, versus a non-viable organ, was revolutionary until the late 1960s. When introduced, the concept opened the whole question of how the immune system works, a question that still continues today. Investigators are trying to identify how to strike a balance between keeping a transplant going without risking infection and the possible onset of other diseases.
In viable solid organ transplantation, the biggest concern is whether or not the patient's body will reject the organ, in which case a pathological condition can occur called graft versus host disease, where cells from the transplanted tissue of a donor spark an immunologic attack on the cells and tissue of the recipient.
In bone marrow transplants, the opposite scenario occurs because a more normal immune system from the transplant donor is put into a recipient whose immune system is paralyzed. Thus the organ can reject the person, making it even more critical to find the perfect match in donor marrow.
For more than 35 years, Navy investigators have focused their research on the set of genes that influence whether an organ transplant is accepted or rejected, especially bone marrow. The gene set of greatest concern in marrow transplants is called Human Leukocyte Antigen (HLA). Military casualties may be rescued using HLA matched platelets and, in the most severe cases, marrow donations.
Managed by the Naval Medical Research Center, the DoD's BYMDP was founded in 1985. It is named for Rep. C. W. Bill Young (R-Florida), who lobbied Congress to initiate a national registry for bone marrow donors. In 1991, the Department of Health and Human Services assumed management of the civilian portion of the registry and it was officially named the National Marrow Donor Program (NMDP).
BYMDP's mission in the treatment of radiation and chemical weapon exposure is unique to the Armed Forces. Identifying donors and receiving platelets or marrow donations can be a matter of days rather than months. However, because marrow transplantation is also instrumental in the treatment of cancer, the benefits of BYMDP's research and data collection efforts continue to spill over into the civilian community. Today, the Navy still maintains data and recruits volunteer donors within the military community under BYMDP. About 12 percent (more than 300,000) of bone marrow donors are registered through the DoD program. Participants may be selected as donors to fellow service members and their families as well as civilians.