– The likelihood of a registered donor being asked to donate is about 1 in 500.

What can be done to mitigate increased GVHD from HLA-mismatch?

No other preference for mismatched loci (HLA-A/B/C/DRB1) or other allele combinations. – Improved matching criteria, knowledge of which HLA loci are important to outcomes, permissive versus non-permissive matches. For a haploidentical (half-matched) transplant, donors match exactly half, or 5 of 10, HLA markers. 2012. pp. In multivariable analysis, a 6/8 matched transplantation in earlier stage malignant disease produces superior survival to 8/8 matched transplantation late in the course of disease. – Tailoring of conditioning regimen intensity based on patient age, performance, and disease. on the search and selection process. We want you to take advantage of everything Cancer Therapy Advisor has to offer. When an 8/8 donor is not an available option, 7/8 matched unrelated donors, related haploidentical donors and umbilical cord blood represent alternative options for which patient- and provider-level factors are used in graft selection. At 3- and 5-years post-transplant, 8/8 HLA-matched patients with early-stage disease experienced survival rates of more than twice the rates of 8/8 HLA-matched patients with advanced disease: 56% vs. 27%, and 50% vs. 22%, respectively (p <0.001). The first successful unrelated donor transplant was performed in 1973 in New York when a young boy with congenital immunodeficiency received multiple marrow transplants from a donor identified as a match through a blood bank in Denmark. Match, Dehn J, et al. – UCBT retains strong anti-malignancy effects, and permits a greater degree of mismatch than a MUD. Female donors who have never been pregnant are sometimes preferred, but this is controversial. Republished with permission of American Society of Hematology, from Blood, HLA Typing and Matching, Optimal Timing of Transplant vs. Copyright © 2020 Haymarket Media, Inc. All Rights Reserved

– The process is confidential and, for the first year of the transplant, neither the donor nor the recipient can know each other’s identity. Interestingly, disease stage was as critical as the degree of mismatch. The choice is often determined by donor preference.

Financial disclosure: See Acknowledgments on page 140. What is HLA matching? This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. 98.

[1]. The number of potential HLA matches for a given HLA-type in the NMDP registry can be screened informally at no cost by accessing The National Marrow Donor Program’s ”Be The Match”‘ Donor Registry (see references). It might be superior to transplant a patient with aggressive disease early with a mismatched donor, than to delay transplant in order to find a better matched donor. This precludes cryopreservation or extensive ex vivo graft manipulation. 2014; 124(16): 2596-2606. here. In this study, we estimate the URD match rate for patients of White (WH), Hispanic (HIS), Asian/Pacific Islander (API), and African American/Black (AFA) race and ethnic groups. Graft is couriered to the recipient’s transplant center, typically within 24 hours of collection, for a fresh infusion, This depends upon the recipients HLA genotype, haplotype, and the size and diversity of the donor registries, The NMDP (The National Marrow Donor Program). Copyright © 2020 Elsevier B.V. or its licensors or contributors. Bill Young Cell Transplantation Program, High-resolution, matches for antigen recognition domains, Select matched/permissive DPB1 mismatch based on the algorithm developed by Crivello et al, Select donor with single allele mismatched at patient’s homozygous locus (HLA-A/B/C/DRB1), if applicable, Avoid mismatches of allotypes targeted by DSA, including DQA1 and DPA1, Should be considered, especially if the unit is to be diluted post thaw, More recent units may be linked to optimal banking practices depending on the bank, Domestic or international units fulfilling selection criteria, Minimum of 8 high-resolution (HLA-A,-B,-C,-DRB1) for both patient & CBU, Conflicting results in hematological malignancies; Avoid if non-malignant diagnosis, Adult donors (bone marrow or PBSC): 6 of 8 loci match for HLA-A, -B, -C, and -DRB1; each of these loci must be typed at high resolution by DNA-based methods. – The donor will be invited to the nearest donor center and, after testing and consenting, will undergo either a marrow harvest or G-CSF (granulocyte colony-stimulating factor) mobilized peripheral blood collection by apheresis.