Automated nucleotide sequencing reveals substantial disparity between the HLA-A2 genes of bone marrow transplant recipients and donors

Tissue typing in support of unrelated hematopoietic cell transplantation

The success of unrelated hematopoietic cell transplantation (HCT) for the treatment of hematologic malignancies has closely paralleled development of robust typing methods for comprehensive and precise donor-recipient matching. The application of molecular methods in clinical research has led to a more complete understanding of the immunogenetic barriers involving host-vs-graft (HVG) and graft-vs-host (GVH) reactions. Along with the development of less toxic transplant regimens, advances in the prevention and treatment of graft-vs-host disease (GVHD) and in the supportive care of the transplant recipient, improved HLA matching of potential unrelated donors has led to clinical results that begin to compare favorably with that of HLA-identical sibling transplants.

Allogeneic transplantation from donors other than HLA-identical siblings

The decade of the 1990s has witnessed impressive advances in the use of alternative donors for allogeneic transplantations. Through funded collaborative, and single-center research efforts, there is great promise that complete and equal access to allogeneic transplantation will be realized. In the next decade, universal donor availability should maximize the patient's chance of overcoming otherwise fatal disease.