The Rome Transplant Network model compared to the Italian Bone Marrow Donor Registry activity for unrelated donor search process and transplant efficiency for hematologic malignancy

Picardi, Alessandra; Arcese, William; Pollichieni, Simona; Piazza, Fabio Di; Mangione, Ilaria; Gallina, Anna Maria; Cerretti, Raffaella; Cudillo, Laura; Angelis, Gottardo De; Mengarelli, Andrea; Dentamaro, Teresa; Tirindelli, Maria Cristina; Chierichini, Anna; Ferrari, Antonella; Marciano, Renato; Andreani, Marco; Bonifazi, Francesca; Sacchi, Nicoletta

doi:10.1111/trf.14131

Cited by 11 publications

(6 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Unfortunately, due to the high level of HLA polymorphism in the Italian population, 50% of Italian patients who need HSCT are currently unable to find an HLA 8/8 matched donor . Consequently, the characterisation of HR HLA haplotype frequency distribution in the Italian population is helpful for applying a recruitment strategy that increases the diversity of the donor pool.…”

Section: Introductionmentioning

confidence: 99%

High‐resolution analysis of the HLA‐A, ‐B, ‐C and ‐DRB1 alleles and national and regional haplotype frequencies based on 120 926 volunteers from the Italian Bone Marrow Donor Registry

Sacchi

Castagnetta

Miotti

et al. 2019

HLA

Self Cite

View full text Add to dashboard Cite

HLA genes are highly polymorphic and structurally complex. They are located in the major histocompatibility complex (MHC) on chromosome 6, and the frequency of alleles and haplotypes varies widely among human populations. In this paper, we calculated the allele and haplotype frequencies using the HLA data of more than 120 000 Italian unrelated bone marrow donors enrolled in the national registry (IBMDR) and typed them with a high‐resolution (HR) method for the HLA‐A, ‐B, ‐C and ‐DRB1 alleles. The allele frequency data were obtained by manual counting; haplotype frequencies were calculated using the expectation maximisation (EM) algorithm. The total numbers of observed alleles were 226 for HLA‐A, 343 for HLA‐B, 201 for HLA‐C and 210 for HLA‐DRB1, which account for 5.4%, 6.7%, 5.2% and 8.5%, respectively, of each locus allele (IPD‐IMGT/HLA Database Release 3.32, April 2018). The three most frequent Italian haplotypes were HLA‐A*01:01~B*08:01~C*07:01~DRB1*03:01 (2.5%), A*02:01~B*18:01~C*07:01~DRB1*11:04 (1.1%) and A*30:01~B*13:02~C*06:02~DRB1*07:01 (1.1%). Moreover, for a relevant subset of the examined population (>100 000 individuals), the birthplace was available, and thus, we grouped the frequency data based on the corresponding Italian geographic areas, describing the HLA specificity of the Italian regional populations. The haplotype frequencies were also compared between national and regional data, and we observed remarkable differences in the regional haplotype frequencies, particularly in Sardinia. This study represents a valid tool to identify a more efficient haematopoietic stem cell unrelated donor recruitment and selection strategy, as well as for population genetic and HLA‐disease association fields.

show abstract

Section: Introductionmentioning

confidence: 99%

High‐resolution analysis of the HLA‐A, ‐B, ‐C and ‐DRB1 alleles and national and regional haplotype frequencies based on 120 926 volunteers from the Italian Bone Marrow Donor Registry

Sacchi

Castagnetta

Miotti

et al. 2019

HLA

Self Cite

View full text Add to dashboard Cite

show abstract

“…This finding is important because, from a practical standpoint, waiting for an URD for a patient with very high-risk or refractory disease is often a risky, or even unreasonable, option. Identifying a suitable URD usually takes longer than 2 months, even in high-income countries [63], which delays the transplantation procedure [64] and impairs the optimal timing for these urgent transplantations, whereas a haploidentical donor can be cleared for donation in just 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

Haploidentical Transplantation with Post-Transplant Cyclophosphamide versus Unrelated Donor Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis

Arcuri

Aguiar

Ribeiro

et al. 2019

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

Hematopoietic stem cell transplantation (HSCT) is the standard treatment for patients with high-risk hematologic malignancies. Only approximately 25% of siblings are HLA-matched, and thus alternative donors-unrelated or haploidentical-are usually the only options available. This meta-analysis aimed to compare haploidentical HSCT with post-transplantation cyclophosphamide and unrelated donor (URD) HSCT. We searched the PubMed and Cochrane databases for pertinent studies indexed between 2008 and 2018. Twenty observational studies (with a total of 1783 haploidentical HSCT recipients and 6077 URD HSCT recipients) were included. Results for overall survival, graft-versus-host disease (GVHD), nonrelapse mortality (NRM), and relapse incidence were pooled. Measures of association used were hazard ratios and risk differences. The median age was 51 years for haploidentical transplant recipients and 52 years for URD transplant recipients. Peripheral blood stem cell (PBSC) grafts were more frequent in the URD transplant recipients (85%) than in the haploidentical transplant recipients (31%). Overall survival was not different between the 2 groups. NRM was lower for haploidentical transplantation. All forms of GVHD (acute grades II-IV and III-IV and moderate, severe, and extensive chronic) were lower with haploidentical donor HSCT. The risk of chronic GVHD was fairly proportional to the differential use of PBSC grafts across studies, however. All included studies were retrospective, representing the major limitation of this meta-analysis. In conclusion, haploidentical HSCT for hematologic malignancies achieved the same overall survival as URD HSCT, with a lower incidence of GVHD and NRM. The increased frequency of PBSC use in the unrelated donor group could partially explain the higher cGVHD rate. Haploidentical transplantation with post-transplantation cyclophosphamide should strongly be considered as the first option for adult patients with hematologic malignancies who do not have matched sibling donors in experienced centers. This systematic review has been registered at PROSPERO (65790).

show abstract

“…Примерный алгоритм поиска HLA-совместимого неродственного донора приведен на рисунке 2 (алгоритм Итальянского регистра доноров костного мозга) [20].…”

Section: рекомендации по Hla-типированию и оценке Hla-совместимости бunclassified

Assessment of Hla-Compatibility and Requirements for Hla-Typing of Patient and Donor in Allogeneic Hematopoietic Stem Cell Transplantation

Хамаганова¹,

Кузьмина²

2019

Gematologiâ i transfuziologiâ

View full text Add to dashboard Cite

Introduction. Unification of guidelines and standards concerning requirements for HLA typing and assessment of the degree of HLA match between the recipient and the donor for different types of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is of a great importance.Aim. To present contemporary requirements for the HLA typing of a recipient and a donor for allo-HSCT, to generalize recom mendations for assessing a required match degree of a recipient and a donor and to provide data on additional immunogenetic factors capable of improving the results of allogeneic hematopoietic stem cell transplantation.General findings. Allo-HSCT appears to be an effective, and, in some cases, non-alternative treatment for many diseases of the blood system. The number of allo-HSCT types is constantly growing globally. Currently, an allogeneic hematopoietic stem cell donor can be selected for almost every recipient having indication for this type of therapy. Such a transplantation can be performed from an HLA-identical sibling, an HLA-match unrelated donor, a partially HLA-match unrelated donor, a relative haploidentical donor or cord blood. HLA match between the recipient and the donor present itself as an important factor affecting the results of allo-HSCT. The choice of a donor should involve a correct assessment the HLA match degree between the recipient and the donor, as well as consideration of additional factors that may affect the results of allo-HSCT.

show abstract

The Rome Transplant Network model compared to the Italian Bone Marrow Donor Registry activity for unrelated donor search process and transplant efficiency for hematologic malignancy

Abstract: Both PQ and HR HLA at the start of the process represents a useful tool to address the search towards the best and timely donor choice. Moreover, establishing a specific donor policy significantly improves the transplant efficiency.

Cited by 11 publications

References 44 publications

High‐resolution analysis of the HLA‐A, ‐B, ‐C and ‐DRB1 alleles and national and regional haplotype frequencies based on 120 926 volunteers from the Italian Bone Marrow Donor Registry

High‐resolution analysis of the HLA‐A, ‐B, ‐C and ‐DRB1 alleles and national and regional haplotype frequencies based on 120 926 volunteers from the Italian Bone Marrow Donor Registry

Haploidentical Transplantation with Post-Transplant Cyclophosphamide versus Unrelated Donor Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis

Assessment of Hla-Compatibility and Requirements for Hla-Typing of Patient and Donor in Allogeneic Hematopoietic Stem Cell Transplantation

Contact Info

Product

Resources

About