Donor Statement of Consent

I wish to register with DKMS US as a potential bone marrow or peripheral blood stem cell donor and agree to the following:

  • I have read the educational material provided and my questions have been answered satisfactorily.
  • I have read the Donor Registration Terms and consent to its terms.
  • According to my knowledge, I meet the eligibility requirements to become a registered bone marrow or peripheral blood stem cell donor.
  • I have provided accurate and complete contact information and agree to inform DKMS US of any changes.
  • I transfer the ownership of the sample which was taken from my buccal swab to DKMS US.
  • I consent to the sample being analyzed in a pseudonymized form (only linked to a number) for the purpose of donor registration by the DKMS Life Science Lab gGmbH. The laboratory analysis includes the genetic examination of my tissue characteristics of the stem cells (HLA) and other potentially transplantation-relevant factors. Any sample leftover is stored indefinitely for the determination of transplantation-relevant factors in the laboratory of DKMS Life Science Lab gGmbH.

With regard to the registration with this consent form and my sample submission, I agree that DKMS US and the DKMS Group gGmbH (legally independent companies, but acting as joint controllers as far as necessary):

  • Store personal data to identify me (e.g. name, address, date of birth) as well as medical data about my health and genetic data from the laboratory analysis mentioned above in order to include me in the DKMS donor database, to check my donor eligibility and to carry out the associated update of my donor profile;
  • Transmit search-relevant data (e.g. age, sex, HLA) exclusively in pseudonymized form to international donor search registries for the search to become a potential suitable donor;
  • Use my contact details (incl. e-mail and phone) to contact me should I be considered a suitable donor.
  • If a previously unknown tissue characteristic (allele) is identified during the analysis of my sample, the DKMS Life Science Lab gGmbH may publish this allele under its name at the responsible institutions (European Nucleotide Archive (ENA), IPD-IMGT/HLA database). No information on the origin of the allele will be provided.
  • I am aware that I can withdraw my consent at any time without giving reasons to DKMS US (by phone at 212-209-6700 or by email at In case of withdrawal my data will be deleted unless otherwise provided by law.
  • I have taken note of the further information on the Donor Registration Terms.