The MHC in human bone marrow allotransplantation

E. J. Yunis, Z. Awdeh, Donald Douglas Raum, C. A. Alper

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

In this chapter, we have considered the theoretical and practical background of bone marrow transplantation. The immune response and its regulation by genes within the major histocompatibility complex, particularly of the I region of the mouse and of the HLA-D/DR region in man, is of central importance in both graft acceptance (rejection) and graft-versus-host disease. Methods which are available for typing alleles at the HLA-A, -C, -B, -DR and complotype (BF, C2, C4A, C4B) loci, have been considered in detail. The extent to which recombination affects specific alleles on haplotypes within families is discussed, as is the occurrence of linkage disequilibrium and extended haplotypes in populations of unrelated individuals. Because the HLA-DR and complotype region in man is thought to be critical for the success of bone marrow transplantation, methods for typing of HLA-D by both the HTC and PLT approaches have been examined. Although HLA-D/DR assignments are easily made in normal subjects, they are ambiguous in about 50 per cent of candidates for bone marrow transplantation, including, particularly, patients with aplastic anaemia, leukaemia, and severe combined immunodeficiency. In this setting, it is particularly important to obtain additional information by modification of HLA-D typing procedures and through complotype and GLO allele determinations in all family members. Finally, we can hope that there will be an increased possibility of using non-family donors through methods for removing cytotoxic T cells from donor marrow and through the identification, in the general population, of individuals who are genotypically similar or identical to the recipient. In this regard, the recognition that some 30 per cent of chromosome 6 in caucasians (50 per cent of individuals) bear extended haplotypes, which include a relatively fixed set of alleles particularly in the HLA-B, -DR, complotype and GLO regions, offers considerable promise.

Original languageEnglish (US)
Pages (from-to)641-680
Number of pages40
JournalClinics in Haematology
Volume12
Issue number3
StatePublished - Oct 1983
Externally publishedYes

Fingerprint

HLA-D Antigens
HLA-DR Antigens
Bone Marrow
Bone Marrow Transplantation
Alleles
Haplotypes
Hope
Tissue Donors
HLA-C Antigens
Severe Combined Immunodeficiency
Histocompatibility Testing
Chromosomes, Human, Pair 6
HLA-A Antigens
HLA-B Antigens
Aplastic Anemia
Linkage Disequilibrium
Graft Rejection
Graft vs Host Disease
Major Histocompatibility Complex
Genetic Recombination

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Yunis, E. J., Awdeh, Z., Raum, D. D., & Alper, C. A. (1983). The MHC in human bone marrow allotransplantation. Clinics in Haematology, 12(3), 641-680.

The MHC in human bone marrow allotransplantation. / Yunis, E. J.; Awdeh, Z.; Raum, Donald Douglas; Alper, C. A.

In: Clinics in Haematology, Vol. 12, No. 3, 10.1983, p. 641-680.

Research output: Contribution to journalArticle

Yunis, EJ, Awdeh, Z, Raum, DD & Alper, CA 1983, 'The MHC in human bone marrow allotransplantation', Clinics in Haematology, vol. 12, no. 3, pp. 641-680.
Yunis EJ, Awdeh Z, Raum DD, Alper CA. The MHC in human bone marrow allotransplantation. Clinics in Haematology. 1983 Oct;12(3):641-680.
Yunis, E. J. ; Awdeh, Z. ; Raum, Donald Douglas ; Alper, C. A. / The MHC in human bone marrow allotransplantation. In: Clinics in Haematology. 1983 ; Vol. 12, No. 3. pp. 641-680.
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