How is the donor's marrow matched to the patient's marrow in allogeneic or syngeneic transplantation?

To increase the likelihood of successful transplantation and to minimize potential complications, it is important that the transplanted marrow match the patient's own marrow as closely as possible. People usually have different sets of proteins, called human leukocyte-associated (HLA) antigens, on the surface of their cells. The set of proteins, called the HLA type, is identified by a special blood test.

The success of allogeneic transplantation depends largely on how well the HLA antigens of the donor's marrow match those of the recipient's marrow. The higher the number of matching HLA antigens, the greater the chance that the patient's body will accept the donor's bone marrow. Close relatives, especially brothers and sisters, are more likely than unrelated people to have HLA-matched bone marrow.

However, only 30 to 40 percent of patients have an HLA-matched sibling or parent. The chances of obtaining HLA-matched marrow from an unrelated donor are small, but there has been an ... more.

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