Why Black and African American Bone Marrow Donors Are Needed

The short answer

Black and African American patients are far less likely than white patients to find a fully matched, unrelated bone marrow donor. Published U.S. registry data shows the chance of finding a closely matched adult donor is roughly 75 percent for patients of white European ancestry but under 20 percent for patients of African ancestry, according to a peer-reviewed analysis of the national registry and figures from the federal Health Resources and Services Administration (HRSA).

That gap is not about willingness to donate. It is about math and genetics. The proteins doctors use to match a donor to a patient are inherited, and patients are most likely to match someone who shares their ancestry. When fewer people of a given background have joined a registry, patients from that background have fewer potential matches to draw from. More registered donors from Black and African American communities directly raises the odds for future patients from those communities.

The Jada Bascom Foundation is a nonprofit that helps people understand donation and points them to the official donor registry for their country. We do not run a registry, mail swab kits, or perform HLA testing ourselves — those steps are handled by the registries we link you to. What we can do is explain why this matters and help you take the first step.

Why July is African American Bone Marrow Awareness Month

July is observed as African American Bone Marrow Awareness Month, an awareness period historically promoted by NMDP (formerly Be The Match), the largest U.S. bone marrow registry organization. It is a recognized awareness observance rather than a federally designated month, and it exists to spotlight a specific, fixable disparity: the shortage of matched donors for Black and African American patients who need a transplant.

The month is a good moment to learn the "why" — and to act on it — but the need is year round. A patient searching for a donor in December faces the same odds as one searching in July.

Why ancestry affects HLA matching

Bone marrow matching is not based on blood type. It is based on a set of genetic markers called HLA — human leukocyte antigens — that sit on the surface of nearly every cell in your body. Your immune system reads these markers to tell "self" from "not self." In a transplant, the donated cells become the patient's new immune system, so those HLA markers need to line up closely or the new cells may attack the body, or the body may reject them.

Here is the key fact: HLA is inherited from your biological parents. As NMDP explains, "a patient's ethnic background is important in predicting the likelihood of finding a match. That's because HLA is inherited." Human populations that were historically separated by geography developed different, characteristic combinations of HLA markers. As a result, you are most likely to match a sibling first, and after that, an unrelated donor who shares your ancestry.

Some ancestral backgrounds also carry more HLA diversity than others. Populations of African descent have some of the most varied HLA types in the world — a reflection of deep human genetic history. That diversity is a strength for the species, but it means a patient of African ancestry needs a larger and more varied pool of registered donors to find a close match. When that pool is small, matches are rare. You can read more about how this test works on our HLA matching explainer, and more about the community impact on our page about donors of color.

What the registry data actually shows

The clearest picture comes from a peer-reviewed analysis of the U.S. registry published in *The New England Journal of Medicine* (Gragert and colleagues), together with data reported by HRSA, which oversees the national program. That research modeled the chance of finding a suitable adult donor by ancestry:

• Patients of white European ancestry had roughly a 75 percent chance of a well-matched adult donor.
• Patients of Hispanic or Latino ancestry fell in the middle, in the range of the mid-30s to around 40 percent.
• Patients of Asian and Pacific Islander ancestry varied widely by subgroup, from the upper 20s to about half.
• Patients of African American and Black ancestry faced the longest odds of any major group — under 20 percent in that analysis.

We cite these figures to HRSA and the peer-reviewed literature, not to any single registry, and we present them as ranges because match probability depends on how the population is defined and which registry pools are searched. The direction of the gap, however, is consistent across every credible source: patients of African ancestry have the hardest time finding a match, and the biggest single lever to change that is more Black and African American donors joining a registry.

Why this matters for blood cancers — and for sickle cell disease

For patients with blood cancers such as leukemia, lymphoma, and myeloma, a bone marrow or blood stem cell transplant can be a critical treatment when other options run out. Finding a matched donor can be the difference between having that option and not having it.

But blood cancer is only part of the story, and it is a part that often gets overlooked in the Black community. A transplant can also be a treatment for inherited blood disorders, most notably sickle cell disease — a condition that, according to the National Heart, Lung, and Blood Institute (NHLBI), affects an estimated 100,000 people in the United States and disproportionately affects people of African ancestry. For some patients with severe sickle cell disease, an allogeneic bone marrow transplant from a matched donor is one of the few potentially curative treatments, as described by NHLBI and the National Cancer Institute (NCI). Outcomes depend on the individual patient, the donor match, and many medical factors, so a transplant is never a guarantee — but for the right patient, a matched donor can open a door that nothing else can.

The cruel overlap is clear: sickle cell disease is most common in exactly the communities that are least represented on donor registries. That is why growing the number of Black and African American donors is not an abstract statistic. It is directly tied to whether a child with sickle cell, or an adult with leukemia, has a real shot at treatment.

What one donor actually does

If you join a registry, the typical first step is a simple cheek swab — no blood draw, no surgery, no cost to you. The registry stores your HLA profile so that if you ever come up as a potential match for a patient, they can contact you. Most modern donations are done through a process similar to donating blood plasma, not a surgical marrow harvest. The registries you join can walk you through every step; the Jada Bascom Foundation's role is simply to help you find the right one and understand what to expect.

Being a potential match is rare and precious. For a patient of African ancestry searching a thin pool, a single well-matched donor can be the only match in the world.

How to help this July

• Find your country's registry and join. Most people who register never get called — but the ones who do can be irreplaceable, especially for underrepresented patients.
• Bring your family and community in. Because HLA is inherited and ancestry-linked, encouraging relatives, friends, and community members to register multiplies the impact within the community that needs it most.
• Share the "why." Many people simply do not know that Black patients face the longest odds, or that a swab can help. Passing along the science — including this page, our HLA matching guide, and our page on donors of color — is real help.

The match gap for Black and African American patients is one of the few problems in medicine that ordinary people can genuinely help solve, without a lab coat and without a dollar. It just takes more people, from more communities, saying yes.

Ready to take the first step? Find the official donor registry for your country and see if you are eligible to join.

Frequently asked questions

Why are Black and African American bone marrow donors especially needed?

Bone marrow matching relies on HLA markers that are inherited, so patients are most likely to match a donor who shares their ancestry. Because fewer Black and African American donors have joined registries, patients from these communities have far fewer potential matches. Published U.S. registry data cited by HRSA shows patients of African ancestry find a matched donor far less often than white patients, so more Black donors directly raises the odds for future patients.

Is July officially African American Bone Marrow Awareness Month?

July is observed as African American Bone Marrow Awareness Month, an awareness period historically promoted by NMDP (formerly Be The Match). It is a recognized awareness observance highlighting the donor match gap for Black patients rather than a federally designated month.

Why does ancestry affect a bone marrow match?

The HLA markers used to match a donor and patient are inherited from your biological parents, and different populations developed different characteristic HLA combinations over history. That is why, after siblings, you are most likely to match an unrelated donor who shares your ancestry. Populations of African descent also carry especially diverse HLA types, so a larger, more varied donor pool is needed to find a close match.

Can a bone marrow transplant help with sickle cell disease?

For some patients with severe sickle cell disease, an allogeneic bone marrow or blood stem cell transplant from a matched donor is one of the few potentially curative treatments, according to the NHLBI and the National Cancer Institute. Sickle cell disease disproportionately affects people of African ancestry, which is one reason more Black and African American donors are so important. Outcomes vary by patient, and a transplant is never guaranteed.

Does the Jada Bascom Foundation run a registry or test my HLA?

No. The Jada Bascom Foundation is a nonprofit that helps people understand donation and points them to the official donor registry for their country. We do not run a registry, mail swab kits, store donor records, perform HLA testing, or decide eligibility. Those steps are handled by the registries we link you to.

How do I join a bone marrow registry?

Find the official donor registry for your country and sign up. The typical first step is a simple cheek swab at no cost to you, and the registry stores your HLA profile in case you are ever a potential match for a patient. The Jada Bascom Foundation can help you find the right registry for where you live.

Sources

• HRSA — Blood Cell / National Marrow Donor Program (federal registry data)
• Gragert et al., HLA Match Likelihoods for Hematopoietic Stem-Cell Grafts in the U.S. Registry, NEJM 2014
• NMDP (formerly Be The Match) — Why Ethnicity and Diversity Matter / African American ancestry
• NMDP — July Is African American Bone Marrow Awareness Month
• NHLBI — Sickle Cell Disease
• National Cancer Institute — Stem Cell Transplant