Paucity of HLA-identical unrelated donors for African-Americans with hematologic malignancies: the need for new donor options.

Paucity of HLA-identical unrelated donors for African-Americans with hematologic malignancies: the need for new donor options.
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DOI:
10.1016/j.bbmt.2008.06.005
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发表时间:
2008-08
影响因子:
4.3
通讯作者:
van Besien, Koen
van Besien, Koen
中科院分区:
医学2区
文献类型:
--
作者:
Dew, Alexander;Collins, Demetria;Artz, Adrew;Rich, Elizabeth;Stock, Wendy;Swanson, Kate;van Besien, Koen

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使用高分辨率技术在HLA A、B、C和DRB 1处鉴定HLA相同的供体/受体对优化了成人无关造血干细胞移植后的存活率。据估计,根据血清学分型,大约50%的非裔美国人有合适的无关捐献者,但关于使用分子技术识别HLA相同无关捐献者的可能性的信息很少。从2002年2月到2007年5月,我们使用国家骨髓捐献者计划®对51例非裔美国人患者进行了无关捐献者检索,仅发现3例HLA完全相同的无关捐献者。相比之下,50(98%)至少有一个,往往是多个适当匹配的脐带血单位可用。很少有非裔美国人接受者有HLA相同的无关捐赠者。为了让更多的非洲裔美国患者进行移植,应研究创新的供体策略,包括成人脐带血移植,单倍相合移植或识别允许的错配。
Identification of an HLA identical donor/recipient pair using high-resolution techniques at HLA A, B, C and DRB1 optimizes survival after adult unrelated hematopoetic stem cell transplant. It has been estimated that roughly 50% of African-Americans have suitable unrelated donors based on serologic typing, but there is little information on the likelihood of identifying an HLA-identical unrelated donor using molecular techniques. From 2/2002 to 5/2007, we performed 51 unrelated donor searches for African-American patients using the National Marrow Donor Program® and found HLA identical unrelated donors for only three. By contrast, 50 (98%) had at least one and often multiple appropriately matched cord blood units available. Very few African-American recipients have HLA-identical unrelated donors. In order to allow more African-American patients to proceed to transplant, innovative donor strategies, including adult cord blood transplantation, haplo-identical transplant or the identification of permissive mismatches should be investigated.
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