01.06.21

The National Marrow Donor Program® (NMDP)/Be The Match’s HLA Today Program Offers Critical Information Early in a Patient’s Disease Course

For patients diagnosed with leukemia, lymphoma, and other life-threatening diseases, a hematopoietic cell transplant (bone marrow or cord blood transplant) may be their best or only hope for a cure.

Recent research has shown performing HLA typing and cytogenetic testing at the time of diagnosis is associated with better patient outcomes.1 It’s important to start the process of finding a suitable, related or unrelated donor for allogeneic hematopoietic stem cell transplantation (HCT) early. Finding a donor can take time, especially if the preliminary search report shows a patient has an HLA type not commonly found on the registry.

To assist in this process, the National Marrow Donor Program®(NMDP)/Be The Match® created a free program, HLA Today, for community hematologist/oncologist to HLA type patients and family members at diagnosis.

The HLA Today program is based on the results of the SWOG 1203 study of high-risk adult patients with AML. The researchers used a disciplined, organized process for early HLA typing and cytogenetic testing, rapid donor identification, and early referral for HCT.

In the study, hematologists/oncologists expedited HLA typing for all patients with high-risk cytogenetics at the time of diagnosis. Early cytogenetic testing and HLA typing allowed for earlier initiation of donor identification and referral for HCT consultation, which led to:

  • 65% transplant rate in CR1 compared to the historical rate of 40% (p <0.001)
  • 37% increase in 2-year overall survival among patients who underwent transplantation compared with patients who did not undergo transplantation (48% vs 35%, respectively p=0.031)

Researchers concluded that better outcomes in poor prognosis patients with AML may be achieved by initiating the process to find family member or unrelated donors at the time of diagnosis and performing HCT consistently in CR1.1

When standards of care are followed, patients are more likely to have HCT in early stage disease. Studies on HCT have revealed that patients who receive transplant in earlier disease stages have better outcomes than those transplanted in more advanced disease stages.2

Through the HLA Today program, physicians can begin the process of finding a donor as early as possible—even before transplant consultation with the patient. The program provides buccal swab kits to community hematologist/oncologists to swab patients and mails kits to family members. Within 7-10 days of receiving the completed buccal swab samples, the physician will receive an email that includes: the patients’ high-resolution HLA typing, search prognosis, which is the likelihood of the patient having a fully matched unrelated donor on Be The Match Registry, and a preliminary search report that includes the number of adult unrelated donor or cord blood units that match the patient. Intermediate-resolution HLA typing of family members will also be provided in a separate email.

There is no cost to the provider, the patient or their family members, and no insurance paperwork to file.

To learn more about HLA Today, please visit BeTheMatchClinical.org/HLAToday or email HLAToday@nmdp.org

The National Marrow Donor Program®(NMDP)/Be The Match® facilitates hematopoietic stem cell transplants, manages the world’s largest registry of potential blood stem cell and cord blood units, conducts research, provides support and resources for patients, and education for physicians.

References

1Pagel JM, Othus M, Garcia-Manero G, et al. Rapid Donor Identification Improves Survival in High-Risk First-Remission Patients With Acute Myeloid Leukemia. JCO Oncology Practice 2020; 16:6, e464-e475

2Pidala J, Lee SJ, Ahn KW, et al. Nonpermissive HLA-DPB1 mismatch increases mortality after myeloablative unrelated allogeneic hematopoietic cell transplantation. Blood. 2014; 124(16): 2596-2606

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