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Maternal HLA Typing and Cord Blood Unit Choice

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Umbilical Cord Blood Banking and Transplantation

Part of the book series: Stem Cell Biology and Regenerative Medicine ((STEMCELL))

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Abstract

Umbilical Cord Blood transplantation (UCBT) can be successful even if donor and recipient are not fully matched for human leukocyte antigens (HLA). This may result, in part, from fetal-maternal interactions during pregnancy. Transplacental trafficking exposes the fetus to the maternal cells and the Non-Inherited Maternal Antigens (NIMA), that generate tolerance as well as immunogenic responses. Moreover, small numbers of maternal cells sensitized to the fetal Inherited Paternal Antigens (IPA) can be found in CB. There is increasing evidence that the fetal-maternal interactions affect UCBT outcomes. To select CB grafts with NIMA matches or shared IPA with the recipients the maternal (CB donor mother) HLA typings need to be included in search algorithms. This approach can be implemented in Registries, requiring “upfront” typing of large numbers of maternal samples, or, for individual patient searches, when no fully matched CB graft can be identified.

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Acknowledgments

We thank Professor Jon J. van Rood and Cladd E. Stevens, MD, MPH for their insight and constructive criticism. We thank Dr. Pablo Rubinstein, Director of the National Cord Blood Program for inspiring discussions and the NYBC National Cord Blood Program staff who perform all of the tasks needed to ensure the quality of the CBUs. We are grateful to the transplant centers who reported on patient characteristics and outcomes after transplantation. We are also indebted to the obstetricians in collaborating hospitals who supported the program, and to the mothers who generously donated their infant’s cord blood to any patient that might need it.

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Authors and Affiliations

  1. National Cord Blood Program, New York Blood Center, 45-01 Vernon Boulevard, 11101, New York, NY, USA

    Andromachi Scaradavou MD

  2. Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., 10065, New York, NY, USA

    Andromachi Scaradavou MD

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  1. Andromachi Scaradavou MD
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Correspondence to Andromachi Scaradavou MD .

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Editors and Affiliations

  1. Leukemia Program, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA

    Karen Ballen

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Scaradavou, A. (2014). Maternal HLA Typing and Cord Blood Unit Choice. In: Ballen, K. (eds) Umbilical Cord Blood Banking and Transplantation. Stem Cell Biology and Regenerative Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-06444-4_4

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