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Bone Marrow Transplantation
Article . 2007 . Peer-reviewed
License: Springer TDM
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The probability of identifying a 10/10 HLA allele-matched unrelated donor is highly predictable

Authors: Tiercy, Jean-Marie; Nicoloso, G; Passweg, Jakob; Schanz, U; Seger, R; Chalandon, Yves; Heim, D; +4 Authors

The probability of identifying a 10/10 HLA allele-matched unrelated donor is highly predictable

Abstract

Identification of an unrelated HLA allele-matched hematopoietic stem cell (HSC) donor is a costly and time-consuming procedure. To improve search logistics, we have limited the search period to 6 months and have introduced a probability estimate of the chances of identifying a 10/10 HLA allele-matched donor. Probabilities were classified as high (>95%), intermediate (50%) and low (<5% chance) based on allele and haplotype frequencies. By analyzing 350 consecutive searches between 2002 and 2005 (1719 donors tested), the probability estimates turned out to be correct for 96% (high), 88% (low) and 56% (intermediate) patients. For searches with a high probability of success, at least one of the 10 most frequent haplotypes in Caucasoids was found in 69% of the patients, but in only 11% of the patients with a low-probability estimate (P<0.00001). Survival probability at 3 years was significantly higher for HSCT patients classified with a high-probability estimate when compared to patients in the intermediate/low-probability groups (74 vs 51 and 54% respectively, P=0.01). The same difference in survival probabilities was observed when only 10/10 matched unrelated HSCT patients were analyzed. In the intermediate-/low-probability groups, patients with alternative (haploidentical, autologous) or mismatched unrelated donors had similar survival estimates. Probability prediction is therefore feasible in the search process for unrelated donors and can guide the therapeutic strategy.

Keywords

Tissue and Organ Procurement, Histocompatibility Testing/statistics & numerical data, Histocompatibility Testing, Registries/statistics & numerical data, Hematopoietic Stem Cell Transplantation, Kaplan-Meier Estimate, Tissue Donors, Tissue and Organ Procurement/statistics & numerical data, Haplotypes, Predictive Value of Tests, 616, Humans, Hematopoietic Stem Cell Transplantation/mortality, Registries, Algorithms, Alleles, Probability, ddc: ddc:616

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    popularity
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    Top 10%
    influence
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    Top 10%
    impulse
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    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
62
Top 10%
Top 10%
Top 10%
bronze