Unrelated donor search prognostic score to support early HLA consultation and clinical decisions.
A simple scoring system that can provide a quick search prognosis at the onset of an adult unrelated donor (URD) search could be a useful tool for transplant physicians. We aimed to determine whether patient human leukocyte Ag genotype frequency (GF) could be used as a surrogate measure of whether or not a potential 10/10 and/or 9/10 URD in the Be The Match Registry (BTMR) can be identified for the patient. GF was assigned on a training data set of 2410 patients that searched the BTMR using the reported ethnic group. A proportional odds model was used to correlate GF with defined search productivity categories as follows: 'Good' (>2 10/10), 'Fair' (1-2 10/10 or No 10/10 and >2 9/10) or 'Poor' (No 10/10 and <3 9/10). A second cohort (n=2411) was used to calculate the concordance by the ethnic group in all three categories. In addition, we validated against an independent cohort (n=1344) resolved as having a 10/10 or 9/10 matched URD. Across the ethnic groups, >90% of cases with 'Good' GF prognosis, 20-26% 'Fair' and <10% 'Poor' had a 10/10 URD. Although not a replacement for an actual URD search, GF offers a quick way for transplant physicians to get an indication of the likely search outcome.
Immunogenetic Operations and Research, National Marrow Donor Program, Minneapolis, MN, USA.
K
K
Wadsworth
Bioinformatics Research, National Marrow Donor Program, Minneapolis, MN, USA.
M
M
Albrecht
Immunobiology & Observational Research, Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
R
R
Fonstad
Immunobiology & Observational Research, Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA.
S
S
Spellman
Bioinformatics Research, National Marrow Donor Program, Minneapolis, MN, USA.
M
http://orcid.org/0000-0002-0198-2064
M
Maiers
Immunogenetic Operations and Research, National Marrow Donor Program, Minneapolis, MN, USA.
J
J
Dehn
D000465:Algorithms; D003658:Decision Making, Computer-Assisted; D005838:Genotype; D006680:HLA Antigens / Q000235:genetics*; D006648:Histocompatibility; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D011379:Prognosis; D012017:Referral and Consultation; D012042:Registries; D000069553:Supervised Machine Learning; D013997:Time Factors; D061349:Unrelated Donors
D006680:HLA Antigens