Why to care about Histocompatible Marrow Donor?
Over the years the increased precision in HLA typing has resulted in clinically notable improvements in outcome as accurate matching at the histocompatibility complex is considered essential to minimize graft versus- host disease and graft failure.
Comparing studies that evaluated the impact of HLA compatibility with the risk of graft versus-host disease and other transplantation outcomes is challenging. The main reason relates to the difficulty in assessing the true degree of incompatibility in the earlier studies; when newer molecular-based typing methods were applied to archived specimens, allele disparities were uncovered among phenotypically identical individuals, and these allele disparities were reportedly functionally relevant.
Who are the preferred Marrow Donors?
Siblings are the preferred Marrow Donor source. However, patients who do not have siblings, or who do not have a match following HLA analysis, should be considered for an unrelated Marrow Donor search. Because finding a suitably matched unrelated Marrow Donor may require 3 to 6 months, early searching is critical in avoiding unnecessary delays in pursuing an allogeneic transplant. An alternative approach in selected patients has been to perform transplantation using cells from a half matched or haploidentical donor. Cord blood transplantation is another option, especially for children who do not have HLA-matched sibling donors.