Matchmaking - Donors In Stem Cell Transplants

What is Human Leukocyte Antigen (HLA) typing and why is it important?

Unlike blood donations, which can be given to the millions and millions of people who share the same blood type, stem cell donors are carefully matched to their recipients on a one-to-one basis.

 The key to finding a good match is a set of molecules called Human Leukocyte Antigens (abbreviated as HLAs), which decorate the surface of peripheral blood stem cells and most other cells. It’s as if all of your cells share the same fingerprints. These “markers” distinguish your cells from potentially dangerous trespassers like viruses, bacteria, or cancer.

Individuals inherit their HLA antigens (tissue type) from their parents. Since this is the case, it makes sense that a ‘match’ for stem cell donation is more commonly found within a family group.

 Individuals inherit their HLA antigens (tissue type) from their parents. Since this is the case, it makes sense that a ‘match’ for stem cell donation is more commonly found within a family group. 

 HLA genes are found on the short arm of chromosome 6 and every individual inherits two sets of antigens: one set from each parent. HLA antigen groups are divided into two major categories: class I and class II.

 Every person harbors their own intricate set of HLA markers, and most of the donor’s markers have to be the same as the recipient’s to be deemed a match. There are so many possible combinations of these markers, however, that not everyone will find a match. The chances of a donor being matched to the patient are anywhere from 1 in 450 to 1 in 750,000 depending on the rarity of the individual’s HLA antigens. The more HLAs that are shared between donor and recipient, the better the match. The HLA system plays a major role in the graft versus host disease (GvHD) response.

The search for a match.

PLAN A

1. Siblings first (Matched Sibling Donor)

Donors are initially sought among the patient’s siblings. Your sibling has a 1 in 4 (25%) chance of being a match. Sometimes they might be too old, or not healthy or just refuse to be a donor.

PLAN B

2. Matched unrelated donors

Stem cell registries search on behalf of thousands of patients in need of a lifesaving stem cell transplant. To facilitate matchmaking, they curate lists of potential donors that doctors can check when their patient needs a stem cell transplant. Every new registrant brings hope to those waiting.

 List of Donor Registries in India

  1. DATRI Blood stem cell donor’s registry

  2. Marrow Donor Registry (India)

  3. DKMS BMST foundation India

  4. GeneBandhu

  5. Jeevan stem cell foundation

  6. The Arjan Vir foundation

  7. StemCyte India

PLAN C

3. Alternative donors

  • Mismatched unrelated donors (not a perfect match but still good enough to be a donor).
  • Cord blood transplants (source of stem cells is the umbilical cord blood of healthy newborns).
  • Haploidentical donors(“half-match”) transplant with a biological parent, child, or siblings.

 

Dr. Madhav Danthala

Consultant - Hemato-Oncology And Bone Marrow Transplant

Manipal Hospitals, Vijayawada

 

 

 

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