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Histocompatibility and Donor Selection Issues

Unrelated donor search prognostic score to support early HLA consultation and clinical decisions

Bone Marrow Transplantation volume 51, pages 1476–1481 (2016)Cite this article

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Abstract

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.

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Acknowledgements

This research was funded by the Office of Naval Research grant N00014-14-1-0028. The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the US Government.

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Authors and Affiliations

  1. Immunogenetic Operations and Research, National Marrow Donor Program, Minneapolis, MN, USA

    K Wadsworth & J Dehn

  2. Bioinformatics Research, National Marrow Donor Program, Minneapolis, MN, USA

    M Albrecht & M Maiers

  3. Immunobiology & Observational Research, Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA

    R Fonstad & S Spellman

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  1. K Wadsworth
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  2. M Albrecht
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  3. R Fonstad
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  4. S Spellman
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  5. M Maiers
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Correspondence to K Wadsworth.

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Wadsworth, K., Albrecht, M., Fonstad, R. et al. Unrelated donor search prognostic score to support early HLA consultation and clinical decisions. Bone Marrow Transplant 51, 1476–1481 (2016). https://doi.org/10.1038/bmt.2016.162

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