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Practice Guideline
. 2012 Jul 12;120(2):259-65.
doi: 10.1182/blood-2012-03-379032. Epub 2012 May 17.

A perspective on the selection of unrelated donors and cord blood units for transplantation

Stephen R Spellman  1 , Mary Eapen, Brent R Logan, Carlheinz Mueller, Pablo Rubinstein, Michelle I Setterholm, Ann E Woolfrey, Mary M Horowitz, Dennis L Confer, Carolyn K Hurley; National Marrow Donor Program; Center for International Blood and Marrow Transplant Research
Affiliations
Practice Guideline

A perspective on the selection of unrelated donors and cord blood units for transplantation

Stephen R Spellman et al. Blood. .

Abstract

Selection of a suitable graft for allogeneic hematopoietic stem cell transplantation involves consideration of both donor and recipient characteristics. Of primary importance is sufficient donor-recipient HLA matching to ensure engraftment and acceptable rates of GVHD. In this Perspective, the National Marrow Donor Program and the Center for International Blood and Marrow Transplant Research provide guidelines, based on large studies correlating graft characteristics with clinical transplantation outcomes, on appropriate typing strategies and matching criteria for unrelated adult donor and cord blood graft selection.

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Figures

Figure 1
Figure 1
Example of an NMDP search report. The columns labeled “HLA Typing/Match Grade/Calculation” include a letter indicating the match status of each allele at the locus indicated (A indicates allele match; P, potential allele match; and M, mismatch), the probability of matching both alleles at the locus (99% for the first donor at each locus). The columns labeled “Composite Predictions” display the probability of a 10 of 10 HLA-A, -B, -C, -DRB1, -DQB1 allele match (99% for first donor) and 8 of 8 HLA-A, -B, -C, -DRB1 allele match (99% for the first donor).
Figure 2
Figure 2
Chart illustrating the HLA- and cell-dose–related factors to be considered in selection of unrelated donors and umbilical cord blood units. Consideration may also be given to HLA-DP permissive versus nonpermissive mismatching when choosing among donors who are equivalent by other criteria.
See this image and copyright information in PMC

References

    1. Hurley CK, Baxter Lowe LA, Logan B, et al. National Marrow Donor Program HLA-matching guidelines for unrelated marrow transplants. Biol Blood Marrow Transplant. 2003;9(10):610–615. - PubMed
    1. Bray RA, Hurley CK, Kamani NR, et al. National Marrow Donor Program HLA matching guidelines for unrelated adult donor hematopoietic cell transplants. Biol Blood Marrow Transplant. 2008;14(S9):45–53. - PubMed
    1. Morishima Y, Sasazuki T, Inoki H, et al. The clinical significance of human leukocyte antigen (HLA) allele compatibility in patients receiving a marrow transplant from serologically HLA-A, HLA-B, and HLA-DR matched unrelated donors. Blood. 2002;99(11):4200–4206. - PubMed
    1. Petersdorf EW, Gooley TA, Anasetti C, et al. Optimizing outcome after unrelated marrow transplantation by comprehensive matching of HLA class I and II alleles in the donor and recipient. Blood. 1998;92(10):3515–3520. - PubMed
    1. Petersdorf EW, Gooley T, Malkki M, et al. The biological significance of HLA-DP gene variation in haematopoietic cell transplantation. Br J Haematol. 2001;112(4):988–994. - PubMed

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