PMID- 36485162
OWN - NLM
STAT- MEDLINE
DCOM- 20221216
LR  - 20230110
IS  - 1520-4383 (Electronic)
IS  - 1520-4391 (Print)
IS  - 1520-4383 (Linking)
VI  - 2022
IP  - 1
DP  - 2022 Dec 9
TI  - Hematology 2022-what is complete HLA match in 2022?
PG  - 83-89
LID - 10.1182/hematology.2022000326 [doi]
AB  - Allogeneic hematopoietic cell transplantation (alloHCT) often represents the only 
      curative treatment for various malignant and nonmalignant disorders. Initially, 
      the only suitable donors were considered human leukocyte antigen (HLA)-matched or 
      partially matched relatives. The founding of international unrelated donor and 
      umbilical cord blood registries expanded unrelated donor options and access for 
      patients. In the absence of a matched sibling donor (MSD) with 13% to 51% 
      availability, the current consensus recommends use of a matched unrelated donor 
      (MUD) at HLA-A, B, C, and DRB1 with consideration of matching at HLA-DPB1 and 
      -DQB1. MUD donor availability (donor willing and available to donate) ranges from 
      29% to 78% with African American patients on the lower end and white non-Hispanic 
      patients with the highest likelihood of a match. Recent studies comparing donor 
      to no-donor treatment options in malignant disease consistently point to 
      substantially better outcomes following alloHCT. In the absence of an MSD or MUD, 
      alternative donor choices turn to haploidentical related (Haplo), mismatched 
      unrelated donor (MMUD), and umbilical cord blood (UCB). Novel strategies for 
      alloHCT, including the use of posttransplant cyclophosphamide-based graft vs host 
      disease prophylaxis, have expanded the safety and effectiveness of transplant 
      procedures across HLA barriers using Haplo and MMUD. The less restrictive 
      matching requirements for UCB transplant are well documented and allow for 
      transplant across multiply mismatched HLA alleles. When all donor options are 
      considered, nearly all patients have an available donor. Here we discuss the 
      likelihood of donor availability, complete HLA match by available donor type, and 
      current controversies warranting future research.
CI  - Copyright (c) 2022 by The American Society of Hematology.
FAU - Spellman, Stephen R
AU  - Spellman SR
AD  - Center for International Blood and Marrow Transplant Research, National Marrow 
      Donor Program/Be The Match, Minneapolis, MN.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Hematology Am Soc Hematol Educ Program
JT  - Hematology. American Society of Hematology. Education Program
JID - 100890099
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Humans
MH  - Histocompatibility Testing
MH  - Unrelated Donors
MH  - *Graft vs Host Disease/prevention & control
MH  - HLA Antigens
MH  - *Hematopoietic Stem Cell Transplantation/methods
MH  - Retrospective Studies
PMC - PMC9821192
COIS- Stephen R. Spellman: no competing financial interests to declare.
EDAT- 2022/12/10 06:00
MHDA- 2022/12/15 06:00
PMCR- 2022/12/09
CRDT- 2022/12/09 12:13
PHST- 2022/12/09 12:13 [entrez]
PHST- 2022/12/10 06:00 [pubmed]
PHST- 2022/12/15 06:00 [medline]
PHST- 2022/12/09 00:00 [pmc-release]
AID - 493558 [pii]
AID - 2022000326 [pii]
AID - 10.1182/hematology.2022000326 [doi]
PST - ppublish
SO  - Hematology Am Soc Hematol Educ Program. 2022 Dec 9;2022(1):83-89. doi: 
      10.1182/hematology.2022000326.