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Unrelated Hematopoietic Stem Cell Donor Matching Probability and Search Algorithm

In transplantation of hematopoietic stem cells (HSCs) from unrelated donors a high HLA compatibility level decreases the risk of acute graft-versus-host disease and mortality. The diversity of the HLA system at the allelic and haplotypic level and the heterogeneity of HLA typing data of the register...

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Autor principal: Tiercy, J.-M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502776/
https://www.ncbi.nlm.nih.gov/pubmed/23198148
http://dx.doi.org/10.1155/2012/695018
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author Tiercy, J.-M.
author_facet Tiercy, J.-M.
author_sort Tiercy, J.-M.
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description In transplantation of hematopoietic stem cells (HSCs) from unrelated donors a high HLA compatibility level decreases the risk of acute graft-versus-host disease and mortality. The diversity of the HLA system at the allelic and haplotypic level and the heterogeneity of HLA typing data of the registered donors render the search process a complex task. This paper summarizes our experience with a search algorithm that includes at the start of the search a probability estimate (high/intermediate/low) to identify a HLA-A, B, C, DRB1, DQB1-compatible donor (a 10/10 match). Based on 2002–2011 searches about 30% of patients have a high, 30% an intermediate, and 40% a low probability search. Search success rate and duration are presented and discussed in light of the experience of other centers. Overall a 9-10/10 matched HSC donor can now be identified for 60–80% of patients of European descent. For high probability searches donors can be selected on the basis of DPB1-matching with an estimated success rate of >40%. For low probability searches there is no consensus on which HLA incompatibilities are more permissive, although HLA-DQB1 mismatches are generally considered as acceptable. Models for the discrimination of more detrimental mismatches based on specific amino acid residues rather than specific HLA alleles are presented.
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spelling pubmed-35027762012-11-29 Unrelated Hematopoietic Stem Cell Donor Matching Probability and Search Algorithm Tiercy, J.-M. Bone Marrow Res Review Article In transplantation of hematopoietic stem cells (HSCs) from unrelated donors a high HLA compatibility level decreases the risk of acute graft-versus-host disease and mortality. The diversity of the HLA system at the allelic and haplotypic level and the heterogeneity of HLA typing data of the registered donors render the search process a complex task. This paper summarizes our experience with a search algorithm that includes at the start of the search a probability estimate (high/intermediate/low) to identify a HLA-A, B, C, DRB1, DQB1-compatible donor (a 10/10 match). Based on 2002–2011 searches about 30% of patients have a high, 30% an intermediate, and 40% a low probability search. Search success rate and duration are presented and discussed in light of the experience of other centers. Overall a 9-10/10 matched HSC donor can now be identified for 60–80% of patients of European descent. For high probability searches donors can be selected on the basis of DPB1-matching with an estimated success rate of >40%. For low probability searches there is no consensus on which HLA incompatibilities are more permissive, although HLA-DQB1 mismatches are generally considered as acceptable. Models for the discrimination of more detrimental mismatches based on specific amino acid residues rather than specific HLA alleles are presented. Hindawi Publishing Corporation 2012 2012-11-13 /pmc/articles/PMC3502776/ /pubmed/23198148 http://dx.doi.org/10.1155/2012/695018 Text en Copyright © 2012 J.-M. Tiercy. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Tiercy, J.-M.
Unrelated Hematopoietic Stem Cell Donor Matching Probability and Search Algorithm
title Unrelated Hematopoietic Stem Cell Donor Matching Probability and Search Algorithm
title_full Unrelated Hematopoietic Stem Cell Donor Matching Probability and Search Algorithm
title_fullStr Unrelated Hematopoietic Stem Cell Donor Matching Probability and Search Algorithm
title_full_unstemmed Unrelated Hematopoietic Stem Cell Donor Matching Probability and Search Algorithm
title_short Unrelated Hematopoietic Stem Cell Donor Matching Probability and Search Algorithm
title_sort unrelated hematopoietic stem cell donor matching probability and search algorithm
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502776/
https://www.ncbi.nlm.nih.gov/pubmed/23198148
http://dx.doi.org/10.1155/2012/695018
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