Banco de donantes voluntarios de células progenitoras hematopoyéticas. Proyecto Panama Dono

[The bank of voluntary donors of hematopietic cells. Panama Dono project]

Alejandro Vernaza-Kwiers1, Elena Blake1, Yina Gutiérrez1, Juan Moscoso1, Luis Ortiz1, Cesar Cuero2, Diana Cedeño3, Hilze Rodríguez3

1. Laboratorio Nacional de Trasplante, Caja de Seguro Social, Panamá, Rep. de Panamá; 2. Organización Panameña de Trasplante, Panamá, Rep. de Panamá; 3. Servicio Hematología, Hospital del Niño, Panamá, Rep. de Panamá.

Publicado: 2024-01-01

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Resumen

Introducción; El Trasplante de Células Progenitoras Hematopoyéticas es actualmente un tratamiento para diferentes desordenes hematológicos malignos y no malignos, que se efectúa cuando existe un receptor con un donante idéntico o haploidéntico para los genes del Complejo Mayor de Histocompatibilidad. En ausencia de donante familiar compatible, hemos creado el Programa de Donantes Voluntarios con tipificación del Sistema HLA. que han expresado su consentimiento de ser donantes y comparten los alelos del Sistema de linfocitos humanos codificados en el brazo corto del cromosoma seis. Materiales y métodos: El presente estudio es un estudio descriptivo, observacional y transversal que presenta los resultados de la búsqueda de donantes voluntarios para receptores sin donante familiar en el Programa Panamá Dono y su aplicación en Panamá. Resultado: De los grupos familiares estudiados que incluye receptor y donantes familiares, un total de 783 personas estudiadas aceptaron voluntariamente ser donantes no relacionados y sus tipificaciones HLA incorporadas al Programa Panamá Dono. Un total de 321 pacientes sin donante idéntico o haploidentico en su grupo familiar, se les ha buscado donante no relacionado en el Programa y se logró Trasplantar el primer receptor con un donante voluntario compatible en 16 genes del Complejo Mayor de Histocompatibilidad en el Hospital del Niño. Conclusión: El Laboratorio Nacional de Trasplante de la Caja de Seguro Social ha logrado crear el Programa de Donantes Voluntarios de Células Progenitoras Hematopoyéticas denominado PANAMA DONO, que consta de 788 panameños que han expresado su consentimiento. En la actualidad una paciente del Hospital del Niño fue trasplantada en 2022 con esta modalidad de donante compatible no relacionado. La compatibilidad idéntica de la receptora con el donante voluntario fue de 16 alelos idénticos del Complejo Mayor de Histocompatibilidad.


Abstract

Introduction: Hematopoietic Progenitor Cell Transplantation is currently a treatment for different malignant and non-malignant hematological disorders, which is performed when there is a recipient with an identical or haploidentical donor for the genes of the Major Histocompatibility Complex. In the absence of a compatible family donor, we have created the Volunteer Donor Program with HLA System typing, who have expressed their consent to be donors and share the alleles of the human lymphocyte system encoded on the short arm of chromosome six. Materials and methods: The present study is a descriptive, observational, and cross-sectional study that presents the results of the search for volunteer donors for recipients without a family donor in the Panama Dono Program and its application in Panama. Results: Of the family groups studied, which included recipients and family donors, a total of 783 persons studied voluntarily accepted to be unrelated donors and their HLA typing incorporated into the Panama Dono Program. A total of 321 patients without an identical or haploidentical donor in their family group have been searched for unrelated donors in the Program and the first recipient was transplanted with a voluntary donor compatible in 16 genes of the Major Histocompatibility Complex in the Hospital del Niño. Conclusion: The National Transplant Laboratory of the Social Security Fund has managed to create the Program of Voluntary Donors of Hematopoietic Progenitor Cells called PANAMA DONO, which consists of 788 Panamanians who have expressed their consent. Currently a patient from the Hospital del Niño was transplanted in 2022 with this unrelated compatible donor modality. The identical compatibility of the recipient with the volunteer donor was 16 identical alleles of the Major Histocompatibility Complex.

Citas

[1] Bodmer WF: The HLA System: introduction. Br Med Bull 1978:34(3):213-216. URL: https://doi.org/10.1093/oxfordjournals.bmb.a071500

[2] Sasazuki T, Juli T, Morishima Y et al. Effect of matching of class I HLA on clinical outcome after transplantation on hematopoietic stem cells from an unrelated donor. Japan Marrow Donor Program. N Engl J Med. 1998:339 (17):1177-1185. URL: https://doi.org/10.1056/NEJM199810223391701

[3] Morishima Y, Sasazuki T, Inoko H. et al. The clinical significance of human leukocyte antigen (HLA) allele compatibility in patients receiving a marrow transplant from serologically HLA-A, HLA-B and HLA-DR matched unrelated donors . Blood, 2002:99(11):4200-4206. URL : https://doi.org/10.1182/blood.V99.11.4200

[4] Lee SJ, Klein J, Haagenson M , et al. High resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation. Blood. 2007:110(13):4576-4583. URL: https://doi.org/10.1182/blood-2007-06-097386

[5] Kawase T, Morisihma Y, Matsuo K. et al. High risk HLA allele mismatch combinations responsably for severe acute graft-versus-host disease and implications for its molecular mechanism. Blood. 2007:110(7):2235-2241. URL: https://doi.org/10.1182/blood-2007-02-072405

[6] Petersdorf EW, Malki M, Gooley TA, Martin PJ. Guo Z. MHC haplotype matching for unrelated hematopoietic cell transplantation. PloSMed. 2007:4(1):e8. URL: https://doi.org/10.1371/journal.pmed.0040008

[7] Tay GK, Witt CS. Christiansen FT. el al. Matching for MHC haplotypes results in improved survival following unrelated bone marrow transplantation. Bone Marrow Transplant. 1995:15(3):381-385.

[8] MHC Sequencing Consortium. Complete sequence and gene map of a human major histocompatibility complex. MHC Sequencing Consortium. Nature. 1999; 401:921-923. URL: https://doi.org/10.1038/44853

[9] Vernaza A, Cuero C, Moscoso J, Ortiz, Gutierrez Y, Blake E, Aguilar R. Frecuencia de genes HLA en la población panameña y su relación con la población mundial Revista Médica de Panama 34(1014) 16-21

[10] Y Itoh N. et al. High-throughput DNA typing of HLA and DRB loci by a PCR-SSOP- Luminex method. Immunogenetics 57(10) 2005. URL : https://doi.org/10.1007/s00251-005-0048-3

[11] Robinson J.A, et al. The IPD and IMGT/HLA Data }Base : allele variant databases, Nucl. Acids Res. 43(2015) D423-31. URL: https://doi.org/10.1093/nar/gku116

[12] Klein J. Saeto. The HLA Sysrtem. N. Engl. J. Med. 2000:343:702 and 343:782. URL: https://doi.org/10.1056/NEJM200009073431006

[13] Parham P. The Immune System. Garlan Publishing. N.Y. and London. 2000, 55.

[14] Rodey, GE. HLA Beyond Tears (2a. Edition) DeNovo, Inc. Durango CO, 2000;16

[15] McKenna, RM, Takemoto SK, Terasaki PI., Anti- HLA Antibodies after Solid Organ Transplantation. Transplantation 2000:69:319. URL: https://doi.org/10.1097/00007890-200002150-00001

[16] Hsu, K. y col. The Journal of Immunology 169: 5118, 2002. URL: https://doi.org/10.4049/jimmunol.169.9.5118

[17] 17.- Crum, KA . et al. Tissue Antigens 56:313, 2000. URL: https://doi.org/10.1034/j.1399-0039.2000.560403.x

[18] Vilches, C and Parham, p. Ann. Rev. Immunol. 20. 217, 2002 URL: https://doi.org/10.1146/annurev.immunol.20.092501.134942

[19] Marsh, SGE, et al. Human Immunol, 64:648, 2003. URL: https://doi.org/10.1016/S0198-8859(03)00067-3

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