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Bone Marrow Transplant

 

Allogeneic Hematopoietic Stem Cell Donor

Choosing a donor

The most important factor in picking a HSCT donor is in HLA matching between donor and recipient.

HLA System 

The HLA gene system on chromosome 6 contain a number of genes that encode for a series of antigens collectively referred to as the major histocompatibility complex (MHC).

MHC class I antigens

  • MHC molecules (called MHC class I antigens and include HLA-A, B, and C).
  • Found on all nucleated cells of the body.
  • Important in the immune system’s recognition of “self”.

MHC class II antigens

  • Other MHC molecules (called MHC class II antigens and include HLA-DRB1).
  • Found only on professional antigen presenting cells (such as B-cells, dendritic cells, monocytes and Langerhans cells). 
  • These molecules are important in the presentation of foreign peptide antigens (such as processed bacterial or viral peptides) to T-cells to initiate activation of the adaptive immune response.

Each individual has two copies of chromosome 6.  One series of HLA genes on one chromosome is called a haplotype.  Each individual inherits one haplotype from one parent and the other haplotype from the other parent.  Each individual therefore has two copies of HLA-A, B, C, and D (one from mom, one from dad).

The most important factor in picking a HSCT donor is in HLA matching between donor and recipient.  Increasing HLA disparity increases the risk of graft versus host disease and rejection of the allograft.

 

 

 

 

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