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Int. J. Mol. Sci. 2018, 19(2), 621; https://doi.org/10.3390/ijms19020621

Major Histocompatibility Complex and Hematopoietic Stem Cell Transplantation: Beyond the Classical HLA Polymorphism

1
Department of Pediatric Hematology and Oncology, IRCCS, Ospedale Bambino Gesu’, 00165 Rome, Italy
2
Division of Stem Cell Transplantation and Regenerative Medicine, Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA 94305, USA
3
Laboratory of Immunogenetics and Transplant Biology, IME Foundation, Policlinic of the University of Tor Vergata, 00133 Rome, Italy
*
Author to whom correspondence should be addressed.
Received: 17 January 2018 / Revised: 11 February 2018 / Accepted: 20 February 2018 / Published: 22 February 2018
(This article belongs to the Section Biochemistry, Molecular and Cellular Biology)
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Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) represents a curative treatment for many patients with hematological malignant or non-malignant disorders. Evaluation of potential donors for HSCT includes a rigorous assessment of the human leukocyte antigens (HLA) match status of family members, and the identification of suitable unrelated donors. Genes encoding transplantation antigens are placed both within and outside the major histocompatibility complex (MHC). The human MHC is located on the short arm of chromosome 6 and contains a series of genes encoding two distinct types of highly polymorphic cell surface glycoproteins. Donors for HSCT are routinely selected based on the level of matching for HLA-A, -B, -C, -DRB1, and -DQB1 loci. However, disease relapse, graft-versus-host-disease, and infection remain significant risk factors of morbidity and mortality. In the same breath, in high-risk patients, graft-versus-leukemia effects inherent in HLA mismatching play a substantial immunological role to limit the recurrence of post-transplant disease. The definition of a suitable donor is ever changing, shaped not only by current typing technology, but also by the specific transplant procedure. Indeed, a more complete understanding of permissible HLA mismatches and the role of Killer Immunoglobulin-like receptors’ genes increases the availability of HLA-haploidentical and unrelated donors. View Full-Text
Keywords: human leukocyte antigens (HLA); major histocompatibility complex (MHC); hematopoietic stem cell transplantation (HSCT); anti-HLA antibodies; natural killer (NK) cells human leukocyte antigens (HLA); major histocompatibility complex (MHC); hematopoietic stem cell transplantation (HSCT); anti-HLA antibodies; natural killer (NK) cells
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Bertaina, A.; Andreani, M. Major Histocompatibility Complex and Hematopoietic Stem Cell Transplantation: Beyond the Classical HLA Polymorphism. Int. J. Mol. Sci. 2018, 19, 621.

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