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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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Donor Selection and Human Leukocyte Antigen Loss Leukemia Relapse After Hematopoietic Cell Transplantation.

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HLA matching in contemporary haematopoietic cell transplantation: Recommendations from the EBMT Practice Harmonisation and Guidelines Committee.

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Donor Selection for Allogeneic Hematopoietic Cell Transplantation.

Katharina Fleischhauer1, Thuong Hien Tran, Roland Meisel

  • 1German Immunogenetics Society (DGI), Munich; Institute for Experimental Cellular Therapy, University Hospital Essen; German Consortium for Translational Cancer Research, Essen-Düsseldorf Site; German Registry for Hematopoietic Cell Transplantation (DRST), Essen; Institute for Immunology, University Hospital Heidelberg.

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|March 23, 2023
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Summary

Selecting the best hematopoietic cell transplantation (HCT) donor is key to improving patient survival. Matching human leukocyte antigens (HLA) and considering other factors optimizes outcomes in HCT.

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Area of Science:

  • Hematology
  • Immunogenetics
  • Transplantation Medicine

Background:

  • Allogeneic hematopoietic cell transplantation (HCT) is a critical treatment for over 3000 German patients annually with hematologic and systemic diseases.
  • Genetic disparities, particularly in human leukocyte antigens (HLA), influence graft-versus-host disease and therapeutic effects.
  • Evidence-based donor selection strategies have significantly improved survival rates in allogeneic HCT.

Purpose of the Study:

  • To establish a German consensus statement on hematopoietic cell transplantation (HCT) donor selection.
  • To identify key immunogenetic and clinical factors influencing HCT outcomes.

Main Methods:

  • A literature search of the PubMed database was conducted.
  • The search focused on immunogenetic and clinical factors relevant to allogeneic HCT donor selection.

Main Results:

  • A complete match for the five major HLA loci (HLA-A, -B, -C, -DR, -DQ) is the primary donor selection criterion.
  • Additional factors include HLA-DP compatibility, donor age and sex, cytomegalovirus serostatus, and blood group.
  • Haploidentical related donors and unrelated donors with a single HLA mismatch are viable alternatives, though associated with a higher mortality risk.

Conclusions:

  • Refined donor selection strategies are crucial for improving patient survival after allogeneic HCT.
  • An interdisciplinary approach utilizing current scientific evidence is essential for optimizing HCT patient outcomes.