A perspective on the selection of unrelated donors and cord blood units for transplantation

Making the genomic leap in HCT: application of second-generation sequencing to clinical advances in hematopoietic cell transplantation

“…5,9 Since sequence-based HLA typing for donor selection became the standard of care at most transplant centers, short-term TRM has dramatically declined. 6 Recent reports from the National Marrow Donor Program show that outcomes for HLAmatched, unrelated donor HCTs (MUD-HCTs) are now comparable to that of HLA-matched related donor HCTs (MRD-HCT), underscoring the critical importance of HLA matching in HCT outcomes. 6 However, GVHD remains a major cause of morbidity and mortality, even after 8/8 and 10/10 MRD and MUD-HCTs, suggesting…”

“…4 The degree of HLA matching between the donor and the recipient strongly determines the recipient's risk for graft-versus-host disease (GVHD), which alongside infection and disease relapse are the three major causes of transplant-related mortality (TRM). 5,6 Unlike HLA matching, which is largely standardized across HLA laboratories at major transplant centers, other clinical aspects of HCT management, including pre-conditioning chemotherapy, prophylactic or therapeutic antibiotic use and disease-relapse monitoring, vary significantly from center to center and by clinician experiences.…”

Unrelated adult stem cell donor medical suitability: recommendations from the World Marrow Donor Association Clinical Working Group Committee

“…Because of the difficulty in matching histocompatibility antigens and other donor characteristics such as donor age and gender, CMV status and blood group, many patients will have a limited number of potentially matched donors. 54 In such cases, the decision regarding the acceptability of donor medical conditions that present a risk to the recipient alone may be left to the transplant center, who are best placed to make an informed risk-benefit judgment on whether to proceed with that particular donor.…”

Matching inside and outside the HLA molecule in allogeneic hematopoietic stem cell transplantation

“…Studies of HSCT survival have provided the basis for the current recommendations from the National Marrow Donor Program (NMDP) and the Center for International Blood and Marrow Transplant Research (CIBMTR) for allele level matching unrelated donors with patients at the HLA-A, -B, -C and -DRB1 loci (8/8 match); 4,5 if unavoidable, a 7/8 match can be used.…”