title: Contribution of HLA-A/B/C/DRB1/DQB1 common haplotypes to donor search outcome in unrelated hematopoietic stem cell transplantation.
abstract: In unrelated hematopoietic stem cell transplantation (HSCT), the prediction of donor search outcome at the time of search initiation is of great value for the physicians to delineate the strategy of patient care. The probability of finding an unrelated donor is high for patients who carry at least 1 of the 10 most common HLA haplotypes in Caucasians. As only 10% to 20% patients respond to this criterion, here we aimed at finding additional common haplotypes to improve the prediction of a successful search. HLA broad HLA-A/B/DRB1 haplotypes that were observed with frequencies ≥0.19% in patient families of European origin and that split into ≤2 predominant 4-digit HLA-A/B/C/DRB1/DQB1 haplotypes were considered as common. Carriage of at least 1 of those in 168 patients of various geographic areas with no family donor was confronted to the chance of finding ≥9/10 HLA-matched unrelated donors. Fifty common 4-digit haplotypes were identified. A higher (P < 5 × 10(-6)) chance of finding a suitable donor was found for 55 of 170 (32%) recipients that carried at least 1 of these common haplotypes. Up to now, estimates classified patients into ≥3 groups of probability with ≥1 intermediate group of poor utility for the clinicians. Considering carriage of these common haplotypes together with the frequencies of alleles and of B/C and DRB1/DQB1 associations, which are carried by patient HLA haplotypes, we could classify the patients into 2 groups of probability with a 98% and 26% chance of finding a donor, respectively. Prediction of search outcome could be improved by including the 50 most common HLA haplotypes in the current approaches.
authors.affiliation: Laboratory of Immunology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, University Paris VII, 48 Boulevard Sérurier, Paris Cedex 19, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Pédron
authors.forename: Valérie
authors.initials: V
authors.lastname: Guérin-El Khourouj
authors.forename: Jean-Hugues
authors.initials: JH
authors.lastname: Dalle
authors.forename: Marie
authors.initials: M
authors.lastname: Ouachée-Chardin
authors.forename: Karima
authors.initials: K
authors.lastname: Yakouben
authors.forename: France
authors.initials: F
authors.lastname: Corroyez
authors.forename: Anne
authors.initials: A
authors.lastname: Auvrignon
authors.forename: Arnaud
authors.initials: A
authors.lastname: Petit
authors.forename: Judith
authors.initials: J
authors.lastname: Landman-Parker
authors.forename: Guy
authors.initials: G
authors.lastname: Leverger
authors.forename: André
authors.initials: A
authors.lastname: Baruchel
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Sterkers
mesh_terms: D000483:Alleles; D002648:Child; D005190:Family; D006680:HLA Antigens / Q000235:genetics* / Q000276:immunology; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D006680:HLA Antigens