Globally, more than 50,000 blood stem cell transplants are carried out annually and the number is increasing each year(1). Stem cell transplants (SCTs) offer hope to patients who are in the advanced stage of the disease or are suffering from conditions that are non-responsive to the treatment. In the case of a matching donor, the success rate of SCTs can be as high as 90% when conditions are detected in the early stages. Let us understand more about finding a matching donor and why it is important.
Matching Donor & the Role of HLAs
SCTs are primarily of two types:
- Allogeneic SCT: The patient uses stem cells from a donor. A donor can be a family member or not related to the recipient.
- Autologous SCT: The patients use their own stem cells.
HLA (human leukocyte antigen) are proteins or markers present on almost all cells of the body. Our immune system uses HLA to recognize our own cells and foreign bodies. The probability of finding a matching donor can be 1 in 20,000(2). Since HLA markers are ethnicity dependent, the chances for an Indian to find a matching donor in public cord blood banks outside India is <10%(3).
In the case of a transplant, the doctor always wants to find a closely matched donor for the following reasons:
- Improves the chances of a successful transplant.
- Promotes engraftment or development of healthy red blood cells.
- Reduces the risk of complications including graft-versus-host disease (GVHD).
Before we delve deeper, let us understand how a matching donor is found.
For patients, newly diagnosed with a condition for which allogeneic hematopoietic stem cell transplantation (HSCT) may be indicated, human leukocyte antigen (HLA) typing along with cytogenetic testing is critical at the time of diagnosis. This allows the process for finding a related or unrelated donor to begin as early as possible, even before your patient has a transplant consultation. Studies on HSCT(4) have revealed that patients who receive transplants in earlier disease stages have better outcomes than those transplanted in more advanced disease stages.
Why Should You Consider Early HLA Typing
The researchers used a disciplined, organized process for early HLA typing and cytogenetic testing, rapid donor identification, and early referral for HSCT. The American Society of Clinical Oncology published the results of a study involving high-risk patients with acute myeloid leukaemia (AML), a type of blood cancer. In this study, expedited HLA typing was carried out for all high-risk patients at the time of diagnosis(4).
Early HLA typing allowed for earlier initiation of donor identification and referral for HSCT consultation which helped in improved(4)
- overall survival of the patients who underwent transplantation.
- improved transplant rate of complete remission.
The study also concluded that better outcomes may also be achieved in AML patients with poor prognosis by initiating the process to find family members or unrelated donors at the time of diagnosis(4).
Upfront HLA typing reports can increase the likelihood of a patient undergoing a transplant at the optimal time. This allows the process for finding a related or unrelated donor to begin as early as possible, even before your patient has a transplant consultation.
LifeCell’s HLA-Typing service, StemMatch is an exclusive service for our enrolled community banking members that determines the exact number of 6/8, 7/ 8, and 8/8 matching stem cell units available for the blood sample in the LifeCell registry. Moreover, you can use this service for your family members and know the matching units available from the largest repository of Indian origin stem cells. A comprehensive report is shared within 15 days and updated annual status is reported based on new samples added in or retrieved from the registry with no additional cost.
To know more about StemMatch or to order the service, call18002665533 or visit StemMatch
- WHO | Haematopoietic Stem Cell Transplantation HSCtx. 2013 [cited 2021 Nov 29].
- Shelar J. India’s first bone marrow donor registry ready [Internet]. Pune Mirror. 2012 [cited 2021 Nov 29].
- Jeevan [Internet]. Jeevan.org. [cited 2021 Nov 29].
- Pagel JM, Othus M, Garcia-Manero G, Fang M, Radich JP, Rizzieri DA, Marcucci G, Strickland SA, Litzow MR, Savoie ML, Spellman SR. Rapid donor identification improves survival in high-risk first-remission patients with acute myeloid leukemia. JCO oncology practice. 2020 Jun;16(6):e464-75.