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DOI: 10.1055/s-0034-1383141
Deutscher Konsensus 2013 zur immungenetischen Spenderauswahl für die allogene Stammzelltransplantation
German Consensus 2013 on Immunogenetic Donor Selection Criteria in Allogeneic Stem Cell TransplantationPublication History
Publication Date:
21 November 2014 (online)
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Zusammenfassung
Der vorliegende 4. deutsche Konsensus zur immungenetischen Spenderauswahl für die allogene Stammzelltransplantation wurde von der Deutschen Gesellschaft für Immungenetik (DGI) und der Deutschen Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation (DAG-KBT) gemeinsam erarbeitet und verabschiedet. Er stellt den gemeinsamen Nenner von mehr als 60 Transplantationseinheiten und fast 20 immungenetischen Sucheinheiten dar, die mehr als 3000 deutsche Patienten jährlich betreuen. Während der 1. Konsensus im Jahre 1996 den Anfang der Ablösung von zellulären und serologischen Methoden der HLA-Testung durch molekulargenetische Verfahren darstellte, wird nun die hochaufgelöste Bestimmung der Antigenbindungsstelle der HLA-Moleküle der 5 wichtigsten Genorte als Standard definiert. Das vorliegende Dokument behandelt die Suche nach verwandten und nicht-verwandten Spendern und alle infrage kommenden Stammzellquellen. Bei Sachverhalten, für die eine eindeutig wissenschaftliche Evidenz vorliegt, gibt dieser Konsensus eine klare Richtschnur vor, während es sonst, soweit möglich, die Handlungsoptionen beschreibt.
Abstract
This paper presents the fourth German consensus on the selection of donors for an allogeneic hematopoietic stem cell transplantation (HSCT) as agreed by the German Society for Immunogenetics (DGI) and the German Working Party for Bone Marrow and Blood StemCell Transplantation (DAG-KBT). It represents the common denominator of over 60 transplant teams and almost 20 immunogenetic search units taking care of over 3000 patients per year in Germany. While the first consensus marked the beginning of the transition from cellular and serological to DNA based methods, this consensus defines high resolution matching for the antigen recognition site of the five most relevant HLA loci as the “gold standard”. The document addresses the search for related and unrelated donors as well as the various sources of stem cells, depicts a clear guideline where evidence is mature and discusses options in areas of ongoing research.
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