Recommendations

Vol. 22 No. 4 (2024): Blood Transfusion 4-2024 (July-August)

Histocompatibility assessment in hematopoietic stem cell transplantation: recommendations from the Italian Society for Immunogenetics and Transplantation Biology (Associazione Italiana di Immunogenetica e Biologia dei Trapianti - AIBT)

Authors

Key words: HLA, Histocompatibility, Stem cell transplantation, anti-HLA antibody, natural killer
Publication Date: 2023-06-12

Abstract

The outcome of allogeneic hematopoietic stem cell transplantation (HSCT) is significantly influenced by the degree of HLA histocompatibility between donor and recipient. To provide shared indications for required histocompatibility testing and interpretation before HSCT, the Italian Society for Immunogenetics and Transplantation Biology (Associazione Italiana di Immunogenetica e Biologia dei Trapianti [AIBT]) gathered members and created a working group to discuss and develop recommendations for histocompatibility assessment in HSCT.
After a review of the literature and multiple panel discussions, AIBT developed up-to-date recommendations for the resolution levels of HLA typing, histocompatibility definitions of patients and donors, importance of anti-HLA antibodies, and significance of NK alloreactivity, which are reported in this document. These recommendations have been shared with the Italian Group for Bone Marrow Transplantation (Gruppo Italiano per il Trapianto di Midollo Osseo, cellule staminali emopoietiche e terapia cellulare [GITMO]) and the Italian National Center for Transplantation (Centro Nazionale Trapianti [CNT]). Notably, the increased use of HLA-mismatched transplantation (i.e., mismatched unrelated, haploidentical) in recent years has made these indications even more relevant for the standardization and improvement of quality of care.
This document represents a useful instrument for health care workers involved in the field of HSCT, enhancing synergy with transplant physicians and enabling greater optimization of the available resources.

Additional Files

Authors

Roberto Crocchiolo - Servizio di Immunoematologia e Medicina Trasfusionale, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy https://orcid.org/0000-0001-8473-202X

Caterina Fusco - Cryopreservation and Ba.S.C.O Unit, Oncohaematology Department Santobono-Pausilipon Hospital Naples, Italy https://orcid.org/0000-0001-8124-6376

Marco Andreani - Laboratory of Transplant Immunogenetics, Department of Hematology/Oncology, Cell and Gene Therapy, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy https://orcid.org/0000-0003-3451-3624

Giovanni Rombolà - SOD Diagnostica Genetica, AOU Careggi, Florence, Italy

Michela Falco - Laboratory of Clinical and Experimental Immunology, IRCCS Istituto Giannina Gaslini, Genoa, Italy https://orcid.org/0000-0002-0317-9830

Cinzia Vecchiato - Servizio Aziendale di Immunoematologia e Trasfusionale, Azienda Sanitaria dell'Alto Adige, Bolzano, Italy https://orcid.org/0000-0003-4926-3314

Lucia Garbarino - S.C. Laboratorio di Istocompatibilità, E O. Ospedali Galliera, Genoa, Italy

Lia Mele - Laboratorio HLA e processazione cellule staminali ematopoietiche, Azienda Ospedaliera SS Antonio e Biagio e C Arrigo, Alessandria, Italy

Benedetta Mazzi - Immunogenetics Laboratory, HLA and Chimerism Dept. of Immunohematology and Blood Transfusion IRCCS Ospedale San Raffaele, Milan, Italy

Alessandra Picardi - UOSC Ematologia con Trapianto CSE, AORN A. Cardarelli, Naples, Italy; Gruppo Italiano per il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare, Bologna, Italy https://orcid.org/0000-0002-0136-7686

Letizia Lombardini - Italian National Transplant Center, National Institute of Health, Rome, Italy

Simona Pollichieni - Gruppo Italiano per il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare, Bologna, Italy

Maria Chiara De Stefano - Italian National Transplant Center, National Institute of Health, Rome, Italy https://orcid.org/0000-0002-0770-1411

Fabio Ciceri - Università Vita-Salute San Raffaele, U.O. Ematologia e Trapianto di Midollo, U.O. Medicina ad indirizzo Onco-Ematologico, IRCCS Ospedale San Raffaele, Milan, Italy; Gruppo Italiano per il Trapianto di Midollo Osseo, Cellule Staminali Emopoietiche e Terapia Cellulare, Bologna, Italy https://orcid.org/0000-0003-0873-0123

Massimo Cardillo - Italian National Transplant Center, National Institute of Health, Rome, Italy https://orcid.org/0000-0002-2776-2297

Franco Papola - Centro Regionale Immunoematologia e Tipizzazione Tissutale Ospedale S. Salvatore, ASL1 Avezzano Sulmona, L'Aquila, Italy

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