Allogeneic Hematopoietic Stem Cell Donor Cell
Choosing a donor
Human Leukocyte Antigen (HLA) System:
This is the most important factor in picking a HSCT donor is in HLA matching between donor and recipient.
Other Non-HLA Factors Considered When Choosing A Donor:
CMV IgG Status of Donor:
- Cytomegalovirus can be transmitted from a donor into a CMV naive recipient causing CMV disease (hepatitis, chorioretinitis, pneumonia, colitis).
- Preferable to use a CMV negative donor if available.
Age, Gender and Parity of Donor:
- Preference for younger donors.
- Higher risk when a female donor who has had children is the donor for a male recipient. This is because anti-HLA antibodies and other non-HLA antibodies may have formed in the female donor from previous pregnancies which may increase the risk of GvHD.
Cell Dose of Umbilical Cords:
- The total nucleated cell count of a cord blood unit (which includes both mature hematopoietic cells and HSCs) is as important as HLA type.
- Generally aim for a total nucleated cell count of >2 x 107/kg of recipient body weight. Lower cell doses have much higher risks of non-engraftment.
- This explains why umbilical cord HSCT is not as commonly performed in adult oncology as in pediatric oncology (adult recipients weigh more).