目前,大约有1900万移民背景的人居住在德国。与通常在西北欧发现的HLA频率相比,大多数人来自人群在遗传上具有不同HLA抗原分布的地区。如果这些人患有严重的血液疾病,异基因干细胞移植可能是治疗的选择。然而,寻找合适的组织相容性造血干细胞供体仍然是一个重大挑战.如果没有匹配的同胞捐赠者,在国际造血干细胞捐献者登记处,只有少数具有相似遗传背景的合适捐献者。“蓝星。NRW项目旨在招募具有迁移背景的新的血液和造血干细胞捐献者,并显着增加该组患者的合适捐献者数量。自2017年12月以来,该项目共招募了9100名具有迁移背景的血液和干细胞捐献者。HLA-A的HLA分型,-B,-C,-DRB1、-DQB1和-DPB1通过下一代测序进行。我们根据HLA频率表评估了罕见等位基因的比例,由<1:1000的频率定义。根据蓝星HLA频率表的罕见HLA等位基因频率。NRW队列与匹配的对照供体队列进行比较:罕见HLA-A,-B,-C,-DRB1和-DQB1等位基因的发生频率是对照组的三倍,但罕见的HLA-DPB1等位基因在对照组中更常见。这种差异对于所有HLA等位基因是非常显著的(p<0.0001对于HLA-A,-B,-C,-DRB1,-DPB1;对于HLA-DQB1,p=0.0002)。此外,两组间罕见等位基因分布存在差异。迄今为止,启动了29次工作,12PBSC,到目前为止,从蓝星号收集了一个BM和三个DLI。NRW队列。单采概率高出两倍(0.18%与0.07%)与对照组相比,明显显示出严重的医疗需求。然而,在BluStar中取消了13个工作。NRW捐赠者队列的取消率几乎是其两倍(45%与25%)。这种具有大样本群组的单一登记分析清楚地表明,具有迁移背景的造血干细胞供体代表了足够的供体库,以服务于具有可比种族的患者。
Currently, approximately 19 million people with a migration background live in Germany. The majority of those descend from regions where the population has a genetically different distribution of HLA antigens when compared to the HLA frequencies usually found in North Western Europe. In case of severe haematological disorders of these individuals, allogeneic stem cell transplantation may be the treatment of choice. However, finding appropriate histocompatible hematopoietic stem cell donors continues to be a major challenge. If no matching sibling donors are available, there are only few suitable donors with a similar genetic background available in international blood stem cell donor registries. The \"BluStar.NRW\" project aimed to recruit new blood and hematopoietic stem cell donors with a migration background and to noticeably increase the number of suitable donors for patients within this group. Since December 2017, a total number of 9100 blood and stem cell donors with a migration background were recruited and typed for this project. HLA typing for HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1 was performed by Next Generation Sequencing. We assessed the proportion of rare alleles according to HLA frequency tables, as defined by a frequency of <1:1000. The rare HLA allele frequencies according to HLA frequency tables of the BluStar.NRW cohort were compared with a matched control donor cohort: Rare HLA-A, -B, -C, -DRB1 and -DQB1 alleles occurred three times more frequent than in the control group, but rare HLA-DPB1 alleles occurred more frequently in the control cohort. This difference was highly significant for all HLA alleles (p < 0.0001 for HLA-A, -B, -C, -DRB1, -DPB1; p = 0.0002 for HLA-DQB1). In addition, the distribution of rare alleles differed between the two groups. To date, 29 work-ups were initiated, 12 PBSC, one BM and three DLI were collected so far out of the BluStar.NRW cohort. The apheresis probability is twofold higher (0.18% vs. 0.07%) compared to the control group which clearly shows a serious medical need. However, 13 work-ups were cancelled in the BluStar.NRW donor cohort which represents an almost twice as higher cancellation rate (45% vs. 25%). This single registry analysis with a large sample cohort clearly indicates that hematopoietic stem cell donors with a migration background represent an adequate donor pool to serve patients of comparable ethnicity.