High resolution typing of 10/10 HLA alleles in sibling donor/recipient pairs – is it justified by revealing existing mismatches undetected in standard matching?
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 6
Abstract
Introduction. Although low resolution HLA-A, -B and -DR typing is usually sufficient for segregation of haplotypes required for approval of sibling donor for allogeneic hematopoietic cells transplantation (allo-HCT), it does not exclude undetected HLA mismatches.Aim. The aim of this study was to perform high resolution typing of stored DNA samples from those sibling pairs transplanted in the past, whose recipients experienced clinically significant GVHD.Material and methods. High resolution HLA-A, -B, -C, -DR, -DQ typing was performed in 30 patients and their sibling donors qualified according to low resolution HLA typing, who underwent allo-HCT for hematological malignancies in 2003-2012 and developed either grade III-IV acute GVHD (5 pts), extensive chronic GVHD (16 pts), or both of any degree (9 pts).Results. No allelic mismatches were detected in any donor-recipient pair. Acute grade III-IV and/or extensive chronic GVHD were present in 10 and 21 pts, respectively, despite the complete matching of 10/10 alleles HLA alleles. In 13 pts (43%) clinically significant GVHD has led to fatal post-transplant course, remaining 17 pts are alive.Conclusions. Standard procedures used for matching of sibling donor-recipient pairs are sufficient, although they cannot exclude mismatched HLA alleles.
Authors and Affiliations
Monika Dzierżak-Mietła, Mirosław Markiewicz, Agnieszka Karolczyk, Patrycja Zielińska, Anna Koclęga, Krzysztof Białas, Sławomira Kyrcz-Krzemień
Keywords
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