HLA Matching in Unrelated Stem Cell Transplantation up to Date

Daniel Fürst; Christine Neuchel; Chrysanthi Tsamadou; Hubert Schrezenmeier; Joannis Mytilineos

doi:10.1159/000502263

HLA Matching in Unrelated Stem Cell Transplantation up to Date

Transfus Med Hemother. 2019 Oct;46(5):326-336. doi: 10.1159/000502263. Epub 2019 Sep 3.

Authors

Daniel Fürst^{1

2}, Christine Neuchel^{1

2}, Chrysanthi Tsamadou^{1

2}, Hubert Schrezenmeier^{1

2}, Joannis Mytilineos^{1

2}

Affiliations

¹ Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, and University Hospital Ulm, Ulm, Germany.
² Institute of Transfusion Medicine, University of Ulm, Ulm, Germany.

Abstract

Unrelated hematopoietic stem cell transplantation (HSCT) has evolved from an experimental protocol to a potentially curative first-line treatment in certain disease instances. Factors enabling this transformation were the optimization of treatment protocols and supportive care as well as the availability of a large number of donors worldwide along with the higher quality and reliability of HLA typing. The main criterion for donor selection is HLA compatibility. In this review we discuss the current clinical evidence of HLA matching in unrelated HSCT. In this context, we address methodical aspects of transplantation immunobiology research and discuss the impact of locus and resolution of HLA differences. Furthermore, we address special constellations such as unidirectional mismatches or the presence of nonexpressed alleles as well as HLA alloimmunization and describe the perspective for HLA typing and matching strategies in the future, given the implementation of novel complete or near-complete gene typing approaches using next-generation sequencing short read technology, which are now entering the standard of clinical care.

Keywords: Bone marrow transplantation; HLA matching; Stem cell transplantation; Unrelated donor.

Publication types

Review