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Transplantation related donors: experience of 1355 Chinese patients
Xiaojing Wang1, Haiyan Sun, Qinghua Li
1Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R. China.
Insights
For Chinese patients without siblings, searching for parents or children (Type II) as stem cell donors is a viable strategy, especially if they share common HLA haplotypes. Extended related donors (Type III) are also a reasonable option in specific haplotype scenarios.
Area of Science:
- Hematology
- Immunogenetics
- Transplantation Science
Background:
- The
Purpose of the Study:
- To evaluate the effectiveness of searching for different types of related donors (siblings, parents/children, extended relatives) for Chinese patients undergoing transplantation.
- To analyze HLA haplotype frequencies and donor matching probabilities in a Chinese population, considering the impact of the one-child policy.
Main Methods:
- Retrospective analysis of 1355 Chinese patients seeking related hematopoietic stem cell donors.
- Definition of 2220 HLA haplotypes through segregation in 555 families.
- Separate analysis of Type I (sibling), Type II (parent/child), and Type III (extended relative) donor searches.
Main Results:
- Identified common HLA haplotypes in China, including A30-B13-DR7, A2-B46-DR9, and A33-B58-DR17.
- The probability of a Human Leukocyte Antigen (HLA)-matched Type II donor was 2.13%, with 4.84% having one locus mismatch.
- Common HLA haplotypes like A30-B13-DR7 were observed in HLA-matched Type II donors.
Conclusions:
- For only children or patients lacking an HLA-matched sibling donor, searching for Type II donors is a valuable strategy, particularly with common haplotypes like A30-B13-DR7.
- Type III donor searches remain a reasonable option when patients possess one common and one uncommon HLA haplotype.
Background And Aims:
Currently in China, many young patients are "only children" due to the one-child policy that has been in place for nearly 30 years; therefore, other related donors become more important due to having no siblings. We evaluated the experience of 1355 Chinese patients searching for three types of transplantation-related donors (siblings, parents or children, extended related donors), which were defined as Type I, II and III donors, respectively) retrospectively in a single center.
Methods:
In this study, 2220 HLA haplotypes were defined by segregation in 555 families and the three different related donor types of 1355 patients were analyzed separately.
Results:
A30-B13-DR7, A2-B46-DR9, A33-B58-DR17, A2-B13-DR12, A11-B75-DR12, A1-B37-DR10, A33-B44-DR13, A2-B46-DR8, A33-B58-DR13 were the most common haplotypes in China. In Type II donors, the probability of HLA-matched was 2.13%, and that of one HLA-A, -B or -DR locus mismatched was 4.84%, respectively. Interestingly, of eight HLA-matched Type II donors, each parent had the same HLA haplotype including A30-B13-DR7, A33-B58-DR17, A11-B75-DR12, A33-B58-DR13, A29-B7-DR7. Therein, four were A30-B13-DR7.
Conclusions:
If the patient who has the most common haplotype in China (A30-B13-DR7) is an only child or not an HLA-matched Type I donor, searching for Type II donors is a meaningful strategy. If the patient has one very common haplotype (A30-B13-DR7) and one relatively uncommon haplotype, searching for Type III donors is still a reasonable strategy.
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