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• W4385814261 abstract "When patients do not have matched siblings or well-matched unrelated donors (MUD), hematopoietic cell transplantation (HCT) can still be successful using an HLA-mismatched unrelated donor (MMUD), in combination with post-transplant cyclophosphamide (PTCy), abatacept, or other novel approaches. This may allow clinicians to choose a suitable donor from a wide range of donor options while optimizing other donor selection characteristics, including donor age. We hypothesized that allowing for 5/8 HLA match level considering high resolution matching at HLA-A, -B, -C and -DRB1, there is potential to close the donor availability gap for all patients regardless of their race/ethnicity. In this work, we estimate the likelihood of matching for all race/ethnic groups at different HLA match thresholds. Our study aimed to assess the potential for identifying an available MUD or MMUD in the National Marrow Donor Program® (NMDP)/Be The Match® (BTM) donor registry for 21 detailed and 5 broad racial/ethnic groups, utilizing high-resolution HLA matching for HLA-A, B, C, and DRB1 at various levels (8/8, 7/8, 6/8, and 5/8). We used donor registry population data from the NMDP/BTM in 2020 and redistributed the donor registry data according to existing population ratios, accounting for demonstrated donor availability. Finally, we utilized a genetic model at the population level to estimate the match likelihood for detailed and broad racial/ethnic groups. 8/8 HLA match likelihoods ranging from 16-74% were obtained for various detailed race/ethnic groups with available donors ≤35 years old. When considering more mismatches within the HLA loci, registry coverage became >99% with a 5/8 HLA match level for donors of all ages or those ≤ 35 years old, with DPB1 T cell epitope permissive matching, or when searching donors outside of their race/ethnic group. Our registry models demonstrate the potential of using MMUDs at various HLA match levels to study whether this will expand access to HCT across race/ethnic groups. Furthermore, expanded donor options may erase the donor availability gap for all patients while allowing for selection of MMUDs with favorable characteristics such as younger age." @default.
• W4385814261 created "2023-08-15" @default.
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• W4385814261 date "2023-08-01" @default.
• W4385814261 modified "2023-10-14" @default.
• W4385814261 title "Existence of HLA-Mismatched Unrelated Donors Closes the Gap in Donor Availability Regardless of Recipient Ancestry" @default.
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• W4385814261 doi "https://doi.org/10.1016/j.jtct.2023.08.014" @default.
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