IMPLICATIONS OF HLA POLYMORPHISM FOR DONOR RECRUITMENT

描述：（改编自研究者摘要） 三十年来，骨髓移植（BMT）已成为标准 治疗许多血液恶性肿瘤的护理。 这个想法 供体，具有与供体相同的HLA-A、B、DR表型的供体。 患者，在家庭成员中发现的时间不到35%， 在无关的捐赠者中不到50%的时间。 此外，少数 患者找到HLA匹配供体的可能性甚至更低。 该项目的总体目标是评估 为骨髓移植寻找不相关的匹配供体 患者作为HLA-A、B、DR表型、种族和地理的函数 受援国和捐助国的位置，以制定预测， 促进招募骨髓捐赠者的管理策略， 种族和地理位置的基础上，并开发工具， 允许根据以下可能性分析临床结局： 无关骨髓移植单倍型匹配而非表型匹配 患者 本项目的具体目标是：（1）比较HLA 不同种族群体和不同地理区域的多态性 （2）估计发现的概率; 6/6 HLA-A、B、DR匹配，6/6或5/6匹配各种种族组， （3）地理上的差异;（4）地理上的差异。 要求每个种族群体和地理区域的捐助者， 实现各种族群体之间的平等机会：（4）评估 欧洲和其他外国骨髓捐献者登记处可以在多大程度上 帮助美国患者找到匹配的捐赠者， 表型多样性：（5）评估HLA 多态性使用DNA分型数据，并估计的概率 在等位基因而不是抗原水平上找到HLA匹配， 种族群体;（6）评估匹配标准变化的影响 基于表型的分子决定， 为每个种族群体找到匹配的捐赠者;（7）开发工具， 允许评估基因型匹配对临床结局的影响， 无关的BMT患者。

DESCRIPTION: (Adapted from Investigator's Abstract) During the last three decades, bone marrow transplantation (BMT) has become the standard care for the treatment of many hematological malignancies. The idea donor, one who possesses the same HLA-A, B, DR phenotype as that of the patient, is found less than 35% of the time among family members and less than 50% of the time among unrelated donors. Furthermore, minority patients have even lower probability of finding an HLA matched donor. The overall goals of this project are to evaluate the feasibility of finding unrelated matched donors for bone marrow transplant (BMT) patients as a function of HLA-A, B, DR phenotype, race and geographical location of recipient and donor, to develop projections which will facilitate management strategies for recruiting marrow donors on the basis of race and geographical location, and to develop tools which will permit analysis of clinical outcomes on the basis of the probability of haplotype match rather than phenotype match among unrelated BMT patients. Specific aims of the project are to: (1) compare HLA polymorphism among various racial groups and in different geographical regions of the United States; (2) estimate the probability of finding a 6/6 HLA-A, B, DR match and 6/6 or 5/6 match various racial groups as well as for geographically defined groups; (3) estimate the number of donors required from each racial group and geographical region in order to achieve equal access among various racial groups: (4) assess the extent to which European and other foreign marrow donor registries can assist U.S. patients in finding a matched donor by contributing to the diversity of phenotypes represented in the registry: (5) evaluate HLA polymorphism using DNA typing data and to estimate the probability of finding an HLA match at the level of allele rather than antigen for each racial group; (6) evaluate the impact of changes in matching criteria based on molecular determinations of phenotype upon the probability of finding a matched donor for each racial group; (7) develop tools which permit evaluation of impact of genotype match on clinical outcomes among unrelated BMT patients.