Oudshoorn M, van Leeuwen A, vd Zanden H G, van Rood J J
Europdonor Foundation, Department of Immunohematology and Blood Bank, University Hospital, Leiden, The Netherlands.
Bone Marrow Transplant. 1994 Jul;14(1):3-8.
Bone marrow transplantation using unrelated donors has become a clinical reality but a large number of challenges remain. One of the most important and a crucial one is locating a suitable donor. To cope with this very large registries have been formed but each of these lacks donors with phenotypes which occur in other registries. To facilitate the search process a collation system designated Bone Marrow Donors Worldwide (BMDW) was started. Several times a year it collects the phenotypes of all donors from all participating registries on a worldwide basis. The data are sorted by phenotype number of the broad antigens; the splits are specified immediately after the broad phenotypes. Here the experience with the first 11 editions is summarized. Although there is a steady increase in the numbers of donors and phenotypes included in BMDW, < 1% of the theoretically possible HLA-A, -B, -DR split phenotypes are so far represented. Furthermore, 70% of these phenotypes are unique, i.e. they occur in one donor only. As a result 30% of the donors have a phenotype which occurs in one registry only. Of 49 Europdonor donors who donated bone marrow, 8 (16%) had a phenotype which did not occur in any of the other registries. Because BMDW indicates in which registry a potential donor can be located, it can reduce search time by 75%. We conclude that the use of BMDW is the fastest and most cost-effective way to locate donors with rare phenotypes, whether or not they are of Caucasoid origin.
使用无关供体的骨髓移植已成为临床现实，但仍存在大量挑战。其中最重要且关键的一项挑战是寻找合适的供体。为应对这一问题，已经建立了大量登记处，但每个登记处都缺乏其他登记处中出现的表型的供体。为便于搜索过程，启动了一个名为“全球骨髓供体”（BMDW）的核对系统。该系统每年数次收集全球所有参与登记处所有供体的表型。数据按宽泛抗原的表型编号排序；在宽泛表型之后立即指定细分类型。本文总结了前11版的经验。尽管BMDW中包含的供体和表型数量稳步增加，但到目前为止，理论上可能的HLA - A、 - B、 - DR细分表型中只有不到1%得到体现。此外，这些表型中有70%是独特的，即仅出现在一名供体中。因此，30%的供体具有仅在一个登记处出现的表型。在49名捐献骨髓的欧洲骨髓捐献者中，有8名（16%）的表型在其他任何登记处都未出现。由于BMDW指明了可以在哪个登记处找到潜在供体，它可以将搜索时间减少75%。我们得出结论，使用BMDW是寻找具有罕见表型供体的最快且最具成本效益的方法，无论这些供体是否为白种人血统。
