Effectiveness of Search for Unrelated Donor of Hematopoietic Stem Cells using Russian System Bone Marrow Donor Search: Experience of RM Gorbacheva Scientific Research Institute of Pediatric Hematology and Transplantation

BONE MARROW TRANSPLANTATION , ,

OA Makarenko, AL Alyanskii, NE Ivanova, MA Kucher, EV Babenko, MA Estrina, DE Pevtsov, AA Golovacheva, EV Kuz’mich, BV Afanas’ev

RM Gorbacheva Scientific Research Institute of Pediatric Hematology and Transplantation; Academician IP Pavlov First St. Petersburg State Medical University, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022

For correspondence: Maksim Anatol’evich Kucher, PhD, 12 Rentgena str., Saint Petersburg, Russian Federation, 197022; Tel: +7(812)338-62-60; e-mail: doctorkucher@yandex.ru

For citation: Makarenko OA, Alyanskii AL, Ivanova NE, et al. Effectiveness of Search for Unrelated Donor of Hematopoietic Stem Cells using Russian System Bone Marrow Donor Search: Experience of RM Gorbacheva Scientific Research Institute of Pediatric Hematology and Transplantation. Clinical oncohematology. 2017;10(1):39–44 (In Russ).

DOI: 10.21320/2500-2139-2017-10-1-39-44

ABSTRACT

Background & Aims. The key condition for allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the presence of HLA-compatible related or unrelated donor. If related donor is not found, further search is carried out in the Bone Marrow Donor Worldwide (BMDW) international data base, which is not effective enough (about 80–85 %), because of genotype specificity of Russian Federation residents. The recruitment procedure using BMDW takes a lot of time and is expensive. Therefore, there are good reasons to develop an alternative Russian data base, Bone Marrow Donor Search (BMDS), which includes data from Russian bone marrow donor registries and has a good potential. The aim is to evaluate the effectiveness of hematopoietic stem cell (HSC) donor search and transplant quality using the BMDS search system.

Methods. 34 allo-HSCT recipients with malignancies and hematological diseases were enrolled in the study in RM Gorbacheva Scientific Research Institute of Pediatric Hematology and Transplantation from November, 2012, to March, 2016. A HLA-compatible donor was found for each patient in the BMDS (www.bmds.info), which includes data from 13 Russian registries of HSC donors.

Results. 34 allo-HSCTs were performed from unrelated donors recruited using Russian registries: 1 in 2012; 3 in 2013; 5 in 2014; 21 in 2015; and 4 in the 1st quarter of 2016. The greatest effectiveness of the BMDS search was in 2015 (14 %, n = 17). In 30 cases (88.2 %) a complete 10/10 compatibility for 5 HLA-gene loci was observed; in 4 cases (11.8 %) there was an incomplete compatibility (9/10). AB0 compatibility was only in 7 cases (20.6 %). In 15 cases (44.1 %) bone marrow was used for transplant harvesting; in 19 cases (55.9 %) peripheral blood stem cells were harvested by means of cytapheresis. The CD34+ count in the transplant was 1.2–12.0 x 106 CD34+ cell/kg (median: 5.0 x 106 CD34+ cell/kg). Engraftment was observed in 79.4 % of cases (n = 27), graft failure in 17.7 % of cases (n = 6), and early posttransplant mortality in 2.9 % of cases (n = 1).

Conclusion. There was an increasing efficiency of search for a HLA-compatible unrelated HSC donor using a Russian BMDS search system for Russian residents with a graft quality similar to the one found in the international BMDW database.

Keywords: hematopoietic stem cell transplantation, unrelated bone marrow donor search, BMDS.

Received: July 13, 2016

Accepted: November 24, 2016

Read in PDF (RUS)pdficon

REFERENCES

  1. Каприн А.Д., Старинский В.В., Петрова Г.В. (ред.) Злокачественные новообразования в России в 2012 г. (заболеваемость и смертность). М.: ФГБУ «МНИОИ им. П.А. Герцена» Минздрава России, 2014. 250 с.
    [Kaprin AD, Starinskii VV, Petrova GV, eds. Malignancies in Russia in 2012 (morbidity and mortality rates). Moscow: FGBU MNIOI im. P.A. Gertsena Minzdrava Rossii Publ.; 2014. 250 p. (In Russ)]
  2. Gratwohl A. Hematopoietic stem cell transplantation: a global perspective. JAMA. 2010;303(16):1617–24. doi: 10.1001/jama.2010.491.
  3. Passweg JR, Baldomero H, Peters C, et al. Hematopoietic SCT in Europe: data and trends in 2012 with special consideration of pediatric transplantation. Bone Marrow Transplant. 2014;49(6):744–50. doi: 10.1038/bmt.2014.55.
  4. Бубнова Л.Н., Павлова И.Е., Глазанова Т.В. и др. Регистры доноров гемопоэтических стволовых клеток. Биомедицинский журнал Medline.ru. 2015;16:751–8.
    [Bubnova LN, Pavlova IE, Glazanova TV, et al. Hematopoietic stem cell donor registers. Biomeditsinskii zhurnal Medline.ru. 2015;16:751–8. (In Russ)]
  5. Афанасьев Б.В., Зубаровская Л.С., Моисеев И.С. Аллогенная трансплантация гемопоэтических стволовых клеток у детей: настоящее, проблемы, перспективы. Российский журнал детской гематологии и онкологии. 2015;2(2):28–42. doi: 10.17650/2311-1267-2015-2-2-28-42.
    [Afanasiev BV, Zubarovskaya LS, Moiseev IS. Allogeneic hematopoietic stem cell transplantation in children: now, problems and prospects. Rossiiskii zhurnal detskoi gematologii i onkologii. 2015;2(2):28–42. doi: 10.17650/2311-1267-2015-2-2-28-42. (In Russ)]
  6. Алянский А.Л., Макаренко О.А., Иванова Н.Е. и др. Развитие регистра неродственных доноров костного мозга в Российской Федерации: опыт НИИ детской онкологии, гематологии и трансплантологии им. Р.М. Горбачевой. Российский журнал детской гематологии и онкологии. 2016;3(2):68–75. doi: 10.17650/2311-1267-2016-3-2-68-74.
    [Alyanskiy AL, Makarenko OA, Ivanova NE, et al. Development of donor bone marrow registry in Russian Federation: experience of Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation. Rossiiskii zhurnal detskoi gematologii i onkologii. 2016;3(2):68–75. doi: 10.17650/2311-1267-2016-3-2-68-74. (In Russ)]
  7. Booth GS, Gehrie EA, Bolan CD, Savani BN. Clinical guide to AB0-incompatible allogeneic stem cell transplantation. Biol Blood Marrow Transplant. 2013;19(8):1152–8. doi: 10.1016/j.bbmt.2013.03.018.
  8. Ширяев С.Н. Эффективность аллогенной трансплантации костного мозга у детей с острыми лейкозами в зависимости от ЦМВ-статуса реципиента и донора: Автореф. дис. ¼ канд. мед. наук. СПб., 2014. 22 с.
    [Shiryaev SN. Effektivnost’ allogennoi transplantatsii kostnogo mozga u detei s ostrymi leikozami v zavisimosti ot TsMV-statusa retsipienta i donora. (Effectiveness of allogeneic bone marrow transplantation in children with acute leukemias depending on donor’s and recipient’s CMV statuses.) [dissertation] Saint-Petersburg; 2014. 22 p. (In Russ)]
  9. Gindina T, Mamaev N, Alyanskiy A, et al. Outcome of allogeneic hematopoietic stem cell transplantation in patients with KMT2A (MLL)-related leukemia, depending on number of transplanted CD34+ cells. Bone Marrow Transplant. 2015;50(Suppl 1):481.