HLA-Matched Unrelated Donors for Patients with Sickle Cell Disease: Results of International Donor Searches |
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| Affiliation: | 1. Monacord, Centre Scientifique de Monaco, Principauté de Monaco, Monaco;2. Eurocord, Hôpital Saint Louis, Institut de recherche Saint Louis, Université Paris Diderot, Sorbonne Paris Cité, Paris, France;3. Center for Cell-Based Therapy, Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil;4. Department of Hematology, Clinics Hospital, University of São Paulo Medical School, São Paulo, Brazil;5. Laboratory of Histocompatibility, Albert Einstein Hospital, São Paulo, Brazil;6. Brazilian Bone Marrow Registry (REDOME), Instituto Nacional do Câncer, Ministério da Saúde, Rio de Janeiro, Brazil;7. Saint Louis Hospital, Assistance Publique Hôpitaux de Paris, Paris, France;8. Bone Marrow Transplantation Centre Leiden, Leiden University Hospital, Leiden, The Netherlands;9. Department of Hematology/Oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, B-1020 Brussels, Belgium;10. Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy;11. Department of Hematology, Churchill Hospital, University of Oxford, Oxford, United Kingdom;12. INSERM U955, Centre Hospitalier Universitaire Henri Mondor, Créteil, France |
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| Abstract: | Sickle cell disease (SCD) is the most common inherited hemoglobinopathy. Hematopoietic stem cell transplantation (HCT) is the sole curative therapy for SCD, but few patients will have a matched sibling donor. Patients with SCD are mostly of African origin and thus are less likely to find a matched unrelated donor in international registries. Using HaploStats, we estimated HLA haplotypes for 185 patients with SCD (116 from a Brazilian center and 69 from European Society for Blood and Marrow Transplantation [EBMT] centers) and classified the ethnic origin of haplotypes. Then we assessed the probability of finding an HLA-matched unrelated adult donor (MUD), considering loci A, B, and DRB1 (6/6), in international registries. Most haplotypes were African, but Brazilians showed a greater ethnic admixture than EBMT patients. Nevertheless, the chance of finding at least one 6/6 potential allelic donor was 47% for both groups. Most potential allelic donors were from the US National Marrow Donor Program registry and from the Brazilian REDOME donor registry. Although the probability of finding a donor is higher than previously reported, strategies are needed to improve ethnic diversity in registries. Moreover, predicting the likelihood of having an MUD might influence SCD management. |
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