Support of Unrelated Stem Cell Donor Searches by Donor Center-Initiated HLA Typing of Potentially Matching Donors

Large registries of potential unrelated stem cell donors have been established in order to enable stem cell transplantation for patients without HLA-identical related donors. Donor search is complicated by the fact that the stored HLA information of many registered donors is incomplete. We carried out a project that was aimed to improve chances of patients with ongoing donor searches to find an HLA-matched unrelated donor. For that purpose, we carried out additional donor center-initiated HLA-DRB1 typing of donors who were only typed for the HLA loci A and B so far and were potential matches for patients in need of a stem cell transplant. In total, 8,861 donors were contacted for donor center-initiated HLA-DRB1 typing within 1,089 donor searches. 12 of these donors have donated stem cells so far, 8 thereof for their respective target patients. We conclude that chances of patients with ongoing donor searches to find an HLA-matched unrelated donor can indeed be improved by donor-center initiated typing that is carried out in addition to the standard donor search process. Our results also raise questions regarding the appropriate use of incompletely typed donors within unrelated donor searches.

[1]  J. Madrigal,et al.  The impact of HLA genotyping on survival following unrelated donor haematopoietic stem cell transplantation , 2010, British journal of haematology.

[2]  M. Oudshoorn,et al.  Monitoring the international use of unrelated donors for transplantation: the WMDA annual reports , 2010, Bone Marrow Transplantation.

[3]  R. Wassmuth,et al.  Estimation of high-resolution HLA-A, -B, -C, -DRB1 allele and haplotype frequencies based on 8862 German stem cell donors and implications for strategic donor registry planning. , 2009, Human immunology.

[4]  G. Ehninger,et al.  Criteria for initiation and evaluation of minority donor programs and application to the example of donors of Turkish descent in Germany , 2009, Bone Marrow Transplantation.

[5]  S. Spellman,et al.  National marrow donor program HLA matching guidelines for unrelated adult donor hematopoietic cell transplants. , 2008, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[6]  M. Maiers,et al.  Advances in the selection of HLA-compatible donors: refinements in HLA typing and matching over the first 20 years of the National Marrow Donor Program Registry. , 2008, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[7]  D. Baier,et al.  Aging of registered stem cell donors: implications for donor recruitment , 2008, Bone Marrow Transplantation.

[8]  M. Oudshoorn,et al.  Eleven million donors in Bone Marrow Donors Worldwide! Time for reassessment? , 2008, Bone Marrow Transplantation.

[9]  Harriet Noreen,et al.  High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation. , 2007, Blood.

[10]  F. Appelbaum,et al.  Hematopoietic-cell transplantation at 50. , 2007, The New England journal of medicine.

[11]  A. Gratwohl,et al.  The probability of identifying a 10/10 HLA allele-matched unrelated donor is highly predictable , 2007, Bone Marrow Transplantation.

[12]  G. Ehninger,et al.  Efficiency of HLA-A, -B, -C, -DRB1 High-Resolution Typings of Newly Recruited Potential Stem Cell Donors. , 2006 .

[13]  J. Sierra,et al.  Donor age and degree of HLA matching have a major impact on the outcome of unrelated donor haematopoietic cell transplantation for chronic myeloid leukaemia , 2006, Bone Marrow Transplantation.

[14]  Thomas J. Smith,et al.  Assessment of Optimal Size and Composition of the U.S. National Registry of Hematopoietic Stem Cell Donors , 2004, Transplantation.

[15]  D. Confer.  The National Marrow Donor Program , 2001, Cancer.

[16]  A. van Leeuwen,et al.  Bone marrow donors worldwide. , 2020, Bone marrow transplantation.