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Prenatal HLA-matching to determine suitability for allogeneic bone marrow transplantation
H van den Berg1, M Verjaal, K Boer
1Emma Children Hospital, Department of Paediatric Oncology, Academic Medical Center, University of Amsterdam, The Netherlands.
Bone Marrow Transplantation
|March 29, 2000
Summary
Prenatal diagnosis of fetal HLA-type enables timely cord blood stem cell transplantation for patients with hematological malignancies. This knowledge guides treatment decisions and optimizes delivery for potential stem cell collection.
Area of Science:
- Immunogenetics
- Hematology
- Perinatology
Background:
- Allogeneic stem cell transplantation is a primary treatment for hematological malignancies.
- Human Leukocyte Antigen (HLA)-identical sibling donors are typically required.
- Maternal pregnancy offers a potential source of HLA-typed cord blood stem cells for transplantation.
Observation:
- Amniocentesis was performed to determine fetal HLA-type in four cases.
- Knowledge of fetal HLA-type influenced patient treatment and delivery management.
- Fetal HLA compatibility with the patient was assessed.
Findings:
- In 25% of cases, the fetus was HLA compatible, necessitating planned delivery for cord blood collection.
- In 75% of cases, spontaneous delivery was possible due to fetal HLA incompatibility.
- Prenatal HLA-typing provided crucial information for clinical decision-making.
Implications:
- Prenatal HLA-typing can optimize the timing and logistics of stem cell transplantation.
- This approach may improve treatment outcomes for patients requiring allogeneic stem cell transplants.
- It allows for strategic planning of delivery to maximize the potential of using sibling-derived cord blood for therapy.
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