An Optimized Search Prognosis Tool to Predict 8/8 HLA Allele-Matched Unrelated Donor Procurement

•An optimized tool can accurately classify 8/8 HLA-matched unrelated donor (URD) search prognosis and procurement.•The tool had comparable accuracy in patients of European ancestry and patients of non-European ancestry.•The tool facilitates prompt triage to 8/8-matched URD or alternative donor trans...

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Bibliographic Details
Published in:Transplantation and cellular therapy 2023-05, Vol.29 (5), p.312.e1-312.e5
Main Authors: Davis, Eric, Archer, Anne, Flynn, Jessica, Nhaissi, Melissa, Rapoport, Candice, Suri, Beth, Wells, Deborah, Papadopoulos, Esperanza, Politikos, Ioannis, Fingrut, Warren B., Scaradavou, Andromachi, Barker, Juliet N.
Format: Article
Language:English
Subjects:
Alleles
Allogeneic transplantation
Alternative donor
Donor procurement
Hematopoietic Stem Cell Transplantation - methods
Humans
Prognosis
Search prognosis
Transplantation, Homologous
Unrelated donor
Unrelated Donors
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Summary:•An optimized tool can accurately classify 8/8 HLA-matched unrelated donor (URD) search prognosis and procurement.•The tool had comparable accuracy in patients of European ancestry and patients of non-European ancestry.•The tool facilitates prompt triage to 8/8-matched URD or alternative donor transplants. For patients in need of allogeneic transplantation who lack an HLA-identical sibling, an 8/8 HLA allele-matched unrelated donor (URD) is a standard alternative. However, delays in URD procurement can adversely impact patient care. Recipient genotype and search assessment (MSKv1.0)-based tools can predict search prognosis for many, but both tools have lower performance in non-European ancestry patients. Using the MSKv1.0 tool, we analyzed searches from 1530 potential allograft recipients (including 863 who underwent transplantation) with the aim of creating an optimized MSKv2.0 search prognosis tool that can classify a URD search as either Good or Poor with a high level of accuracy while also limiting an ambiguous Fair search prognosis regardless of patient ancestry. By MSKv2.0, the 8/8 URD search prognosis distribution was 57% Good, 21% Fair, and 22% Poor in Europeans and 15% Good, 21% Fair, and 63% Poor in non-Europeans. Importantly, compared to MSKv1.0, the likelihood of Fair categorization was reduced to
ISSN:2666-6367
2666-6375
2666-6367
DOI:10.1016/j.jtct.2023.02.016