Searching for an unrelated haemopoietic stem cell donor--a United Kingdom perspective.
The worldwide search for unrelated stem cell donors (now over 6 million) is one of the great success stories of international cooperation in the medical field. The initial search report from Bone Marrow Donors Worldwide estimates the chance of finding a suitably matched donor for a given patient. Registries whose donors are HLA-A, -B and -DR typed present the optimal prerequisite to identify a suitable donor for most patients. High-resolution matching HLA class I and class II alleles of the donor and recipient improves clinical outcome after unrelated donor transplantation. The clinical results of unrelated donor bone marrow transplantation are continually improving reflecting improvements in HLA matching, GvHD prophylaxis and transplantation in a favourable phase of disease. However, matching each HLA allele may or may not be critical for successful stem cell transplantation. Some degree of HLA mismatch ("permissible" mismatches) may be tolerated, especially in children. Cord blood banks provide a supplementary source of unrelated stem cell donors, in particular to patients from ethnic minority groups.
O'Shea
J
J
Anthony Nolan Bone Marrow Trust, Royal Free Hospital, London, United Kingdom.
Cleaver
S
S
Little
A M
AM
Madrigal
A
A
D005190:Family; D005312:Fetal Blood / Q000166:cytology; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells; D006650:Histocompatibility Testing; D006801:Humans; D007231:Infant, Newborn; D019520:Living Donors / Q000600:supply & distribution*; D012042:Registries; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D016896:Treatment Outcome; D006113:United Kingdom