Abstract
The principal limitations of allogeneic bone marrow transplantation are the lack of suitable HLA-matched donors and the complications of graft versus host disease associated with HLA disparities. In the absence of a suitable HLA identical sibling donor, alternative donors such as mismatched related or matched unrelated donors are searched. In these transplants, major and minor histocompatibility differences are often unrecognized by current matching tests, explaining the relatively high frequency of graft failure, graft versus host disease and delayed immune reconstitution. New more sensitive techniques of typing by molecular biology has decreased the probability of finding a fully matched donor for class I and class II HLA antigens (1-5). Despite a bone marrow donor registry which contains more than 4 million bone marrow donors worldwide, some patients cannot be transplanted because of the lack of an HLA identical donor.
Published Version
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