Bone Marrow Donor Selection
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How is bone marrow donor selected?
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@lindsay-0 The eligibility criteria for a stem cell donor are essentially the same as for blood donation. Donors are screened for transmittable diseases such as HIV, hepatitis, West Nile virus, syphilis, and human T-lymphotropic virus (HTLV). However, certain donors with these diseases may still be considered for donation on a case-to-case basis. Because of potential risk for transmission of cancers, age-appropriated screening is also recommended.
The National Marrow Donor Program (NMDP), in collaboration with the Center for International Blood and Marrow Transplant Research (CIBMTR) at the Medical College of Wisconsin, published a set of guidelines for selection of unrelated donors and cord blood units for HCT. [8] When high-resolution HLA-A, HLA-B, HLA-C, and HLA-DRB1 (8/8) HLA matched unrelated donors are available, the recommendations for selection are as follows:
Donor younger than recepient
Select matched/permissive DPB1 mismatch
Minimize mismatches of HLA-DRB3/4/5 and HLA-DQB1
Avoid mismatches of allotypes targeted by donor-specific HLA antibodies (DSAs), including DQA1 and DPA1
When an 8/8 match is unavailable, recommendations for selection of 7/8 unrelated donors are as follows:High-resolution matches for antigen recognition domains for 7 matched alleles
Select HLA-C03:03 vs C03:04 mismatch, if present;
Donor younger than recepient
Select matched/permissive DPB1 mismatch
Minimize mismatches of HLA-DRB3/4/5 and HLA-DQB1
Select donor with single allele mismatched at patient’s homozygous locus (HLA-A/B/C/DRB1), if applicable
Avoid mismatches of allotypes targeted by donor-specific HLA antibodies (DSAs), including DQA1 and DPA1