Unrelated donors selected prospectively by block-matching have superior bone marrow transplant outcome

Hum Immunol. 2000 Feb;61(2):85-91. doi: 10.1016/s0198-8859(99)00147-0.


Previous retrospective studies have demonstrated improved outcome in patients whose donors were matched for non-HLA markers in the MHC as well as for HLA genes. Forty patients receiving transplants from unrelated donors were typed prospectively for HLA and non-HLA markers. Non-HLA markers near HLA-B (beta-block markers) and in the DRB1 introns (delta-block markers) were used to assess MHC match between donors and recipient. Patients whose donors were matched at the beta- and delta-blocks had improved event free survival (63%) compared to patients whose donors were mismatched at one or both blocks (25%) (p < 0.05). Patients whose donors were matched at the beta-block had significantly less severe acute graft versus host disease (p < 0.05). In order to investigate the basis for improved outcome block matching was correlated with HLA matching as determined by DNA sequencing. Beta-block matching was highly correlated with matching for exons 2 and 3 of HLA-B but less so for HLA-C. Delta-block matching was highly correlated with matching for exon 2 of HLA DRB1. It is concluded that matching for non-HLA markers in the MHC improves matching for HLA genes. Further studies are required to determine whether matching for non-HLA markers improves outcome to a greater extent than matching for the HLA genes alone.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation*
  • Child
  • Graft Survival / immunology
  • HLA-B Antigens / analysis
  • HLA-C Antigens / analysis
  • HLA-DQ Antigens / analysis
  • HLA-DQ beta-Chains
  • HLA-DR Antigens / analysis
  • HLA-DRB1 Chains
  • Histocompatibility Testing
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Leukemia, Myeloid, Acute / therapy
  • Matched-Pair Analysis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Prospective Studies
  • Sequence Analysis, DNA
  • Tissue Donors*
  • Treatment Outcome


  • HLA-B Antigens
  • HLA-C Antigens
  • HLA-DQ Antigens
  • HLA-DQ beta-Chains
  • HLA-DQB1 antigen
  • HLA-DR Antigens
  • HLA-DRB1 Chains