HLA-A,-B,-C e DRB1 distribution in the national population– systematic

review for assessment of the adequate inventory size and heterogenic

composition of hematopoietic stem cell registries

ABSTRACT

Background:

Methods: We undertook a systematic review and critical appraisal of… between 2008 and April 2013, using
key search strings…

Results:

Conclusions:

Palavras-chave: HLA, geographic distribution, hematopoietic stem cell

1 BACKGROUND HLA-matched biological siblings are generally

HLA class I and class II, play an important role in
immunity response and in hematopoietic stem cell
transplantation (HSCT) (Buhler, Nunes et al. 2012;
Park and Seo 2012; Lima Bruno A. 2013).
HLA matching is the most important factor
influence the successful stem cell donor selection
and the likelihood of HSCT as well as
transplantation outcome (Dzierzak-Mietla,
Markiewicz et al. 2012). In HSCT, the major impact
came from HLA-A, B, C and -DR antigens (Lee,
Klein et al. 2007; Bray, Hurley et al. 2008; Schmidt,
Baier et al. 2009; Stavropoulos-Giokas, Dinou et al.
2012). The stem cell donor selection includes a
precise assessment of the availability and HLA
match status of donors (Park and Seo 2012) and, on
the other hand, the feasibility of identifying an HLA
match donor depends on the patient’s specific HLA
alleles and ethnicity (Atlas 2006; Dickinson 2007;
Anasetti 2008; Gyurkocza, Rezvani et al. 2010).
preferred as donors ((McCullough, Perkins et al.
2006; Dzierzak-Mietla, Markiewicz et al. 2012), but
only 15-30% of patients have a sibling donor
(McCullough, Perkins et al. 2006). The remainder
patients relied on unrelated bone marrow voluntary
donors or cord blood banks for altruistic use
(Gluckman 2009; Navarrete and Contreras 2009).
Currently, more than 21 million volunteers donors
and cord blood units are registered in the Bone
Marrow Donor Worldwide (BMDW) database
(Bone Marrow Donors Worldwide2013). Despite
that, not all patients, are able to find a suitable
donor, only 50% of patients are transplanted using
an unrelated donor (Raffoux 2010). Patients of
ethnic minorities goups have a low probability
(1/10) of identifying a donor-matched (Atlas 2006;
Rocha and Locatelli 2008).
Due to the high level of molecular variation of HLA
alleles and halotypes, an assessment of HLA-A,-B,-
C e DRB1 distribution need to be performed, in
order to optimized the adequate inventory size and
heterogenic composition of hematopoietic stem cell
registries.
This systematic review was commissioned to
provide a comprehensive assessment of the different
approaches and methodologies used to analyze
HLA-A,-B,-C e DRB1 distribution and their
inference in development an adequate inventory size
and heterogenic composition of hematopoietic stem
cell registries setting up.
A diagram of the search and sifting process is
presented in Figure 1 (a desenvolver).
Eligible for inclusion or segregation of each study
was determined by argument with the others
reviewers.
4 BIBLIOGRAFY

2 METHODS

Search strategy and study selection

Following PRISMA guidelines (Liberati, Altman et
al. 2009), one author (S.M.D.) performed the initial
search through April 2013, using the SDI-
Documentation and Information Services of the
Faculty of Engineering of the University of Porto
database.
The data were extracted from already published
literature and therefore, no institutional research
ethics board approval was needed.
The search strategy was based on combinations of
the terms (‘HLA’ or ‘human leucocyte antigen’ or
‘MHC’) and (‘human population genetics’ or ‘ allele
and halotype frequency’ or ‘geographic distribution’
or ‘demographic diversity’) and (‘hematopoietic
stem cell transplantation’ or ‘bone marrow donors’
or ‘donor recruitment’ or ‘donor planning’).

Inclusion and exclusion criteria

Portuguese, Spanish and English language was
eligible and the search was limited to the last five
years. Review articles were not excluded and they
were revised carefully for valuable information. No
restrictions were made with respect to gender,
ethnicity, and population size and study design.

Data management and assessment

Primary, all studies identified were screened by
author, title, abstracts (when available), year of
publication and editor. The studies were ranked as:
(1) Article for further assessment (2) Article
excluded based on title and abstract or without
outcome of interest (3) Repeated.

Methodological quality
Studies retrieved as (1) were critically appraised for
assessed for methodological quality. The studies
were ranked as (1) Article included in the systematic
review (2) Article exclude: did not meet quality
criteria.

3 RESULTS

Result of the search and sifting process

Description of the included articles

A Stu St V Study
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