ABSTRACT
Introdução: O estudo da frequência dos alelos detectados nos doadores e pacientes previamente selecionados para o transplante de medula óssea permite estimar as reais chances de um paciente em lista de espera encontrar um doador com antígeno leucocitário humano (Human leucocite antigen; HLA) idêntico não relacionado, além de facilitar e direcionar o planejamento do crescimento do Registro Nacional deDoadores de Medula Óssea. Objetivo: Descrever e analisar afrequência dos alelos do sistema HLA de classe I (HLA-A, -B e -C) e classe II (HLA-DRB1 e -DQB1) de doadores e pacientespré-transplante de medula óssea, do Hospital de Câncer deBarretos. Material e Métodos: Um total de 98 amostras dedoadores e 106 amostras de pacientes foi selecionado comtipificações em alta resolução, no período de outubro de 2014a outubro de 2015. As amostras foram tipificadas para os lociHLA-A, -B, -C, -DR e -DQ. Resultados: O predomínio daraça branca reflete a composição étnica do Brasil. As doençasde base mais comuns que levaram o paciente ao transplanteforam a leucemia aguda linfóide (34%) e mieloide (29,2%).Os grupos alélicos mais frequentes nos registros foramA*02, A*24, A*03, A*01, B*35, B*44, C*07, DQB1*03,DQB1*05, DQB1*06, DRB1*01 e DRB1*13. Conclusão: Osresultados encontrados reforçam a importância de conhecero perfil demográfico e imunogenético das regiões do Brasil,contribuindo desta forma na redução do tempo de espera porum doador histocompatível
Introduction: The study of allele frequencies detected in donors and patients previously selected for bone marrow transplantation allows us to estimate the real chances of a patient in the waiting list to find an Human leucocite antigen (HLA) identical unrelated donor. This also facilitates and drives the growth planning of the Brazilian Registry of planning Bone Marrow Transplantation (REDOME). Objective: Describe and analyze the frequency of HLA class I alleles (HLA-A*, -B* and C*) and class II alleles, genotypes, and haplotypes(HLA-DRB1* and -DQB1*) from donors and bone marrowpre-transplant patients. Material and Methods: A total of 98donor samples and 106 patient samples were selected withhigh resolution typing, from October 2014 to October 2015.Samples were typed for HLA-A, -B, -C, -DR and -DQ loci.Results: The predominance of the white race reflects theethnic composition of Brazil. The most common underlyingdiseases that led to transplantation patients were acutelymphoid leukemia (34%) and myeloid (29.2%). The mostfrequent allelic groups were A*02, A*24, A*03, A*01, B*35,B*44, C*07, DQB1*03, DQB1*05, DQB1*06, DRB1*01 andDRB1*13. Conclusion: The results reinforce the importanceof understanding the demographic and immunogenic profilefrom Brazilian Regions. This can contribute to the reduction ofwaiting time for a histocompatible donor.
Subject(s)
Humans , Male , Female , Histocompatibility Testing/statistics & numerical data , Bone Marrow Transplantation/statistics & numerical data , Major Histocompatibility Complex/geneticsABSTRACT
UNLABELLED: Umbilical cord blood (UCB) banks have increased their stock worldwide in the past years. There are more than 230,000 available units today. The ideal UCB graft is a unit that is matched in five or six of six HLA. A, B (low-resolution) and DRB1 (high-resolution) alleles and which has over 2.5 x 107 nucleated cells/kg body weight (BW). Four of six matched units are also used specially if the cell dose gives more than 3 x 10(7) nucleated cells/kg BW. Our unrelated donor UCB transplant program was started in 1996 searching international cord blood banks (Netcord, New York) for patients with a definitive or potential indication for stem cell transplantation who lacked a matched family donor. PATIENTS AND METHODS: From 1995 to 1996, a search was initiated for 87 patients with malignant (n = 56, 37 acute leukemia) and nonmalignant conditions (16 congenital diseases, 14 aplastic anemia). Patient data along with low-resolution A, B, and DR typing were sent to the New York Blood Center, along with a blood sample for high-resolution DRB1 typing. Parallel searches were done in the Netcord database among UCB units with reported high-resolution DRB1 typing. Forty-eight searches were done between 1995 and 2000 (31 with high resolution) and 39 were done between 2000 and 2005 (33 with high resolution). UCB units were considered adequate if they had more than 2.7 x 10(7) cells/kg BW. RESULTS: During the first period, four patients (13%) matched five of six high-resolution unit and 21 (67%) a four of six match. During the second period, 15 patients (46%) found a five of six match and 16 (48%) a four of six match (P = .012). CONCLUSION: Nearly half of our patients find an optimal matched UCB unit for transplantation in international banks. The creation of a local UCB bank in our country is supported by these data.