|LETTER TO EDITOR
|Year : 2022 | Volume
| Issue : 3 | Page : 352-353
National voluntary stem cell donor data pool in India: A need of this hour
Vikash Chandra Mishra1, Vimarsh Raina2
1 Patient Services, Genebandhu, South Extension Part-II, New Delhi, India
2 Patient Services, Genebandhu, South Extension, New Delhi, India
|Date of Submission||12-Feb-2021|
|Date of Acceptance||01-Sep-2021|
|Date of Web Publication||30-Sep-2022|
Dr. Vikash Chandra Mishra
Genebandhu, South Extension Part-II, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mishra VC, Raina V. National voluntary stem cell donor data pool in India: A need of this hour. Indian J Transplant 2022;16:352-3
Human leukocyte antigen (HLA) match at HLA-A,-B,-C,-DRB1, and-DQB1 loci, from matched unrelated donor (MUD) is widely considered as the most favorable hematopoietic stem cell source in cases of not finding a matched related donor for hematopoietic stem cell transplant (HSCT)., The diverse nature of HLA is a major barrier to identifying a MUD. In addition, ethnic and racial minorities also play the main role in MUD search., There are more than 70 stem cell registries globally with more than 37 million donors registered (as of December 2020) to facilitate MUD search globally. Out of these donors, India, has a representation of approximately 0.52 million. The increasing number of registries and donors has improved access to HSCT transplants. However still, lots of efforts need to be done to get MUD for each such needy patient in a country like India wherein every 6 min; somebody is diagnosed with hematological disorders.
As described in [Table 1], we presented a case that had approached us for MUD search. MUD search was done both in national and international registry, but unfortunately, none of the full (10/10) matched HLA compatible donors was identified till December '2020 for this patient. As a stem cell registry, several similar cases were observed each day that do not have MUD for HSCT. MUD searches are typically conducted at the national level before consulting the World Marrow Donor Association global donor pool; benefits to domestic donor use include reduced transplant-associated costs, increased efficiency/logistics, and possible reduced transmission of nonendemic diseases.
|Table 1: Representing age, gender, human leukocyte antigen-phenotype, and matched unrelated donor status|
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The first haplotype occurs at intermediate frequency in the southeast Indian population whereas the second haplotype is rare as per the data obtained from HaploStats. The possibility of similar haplotypes that are seen at lower prevalence than this combination cannot exclude. The search for a full matched donor is difficult due to the uncommon HLA-B genotypes (B*08:01-B*13:01) and one rare haplotype (A*11:01, C*04:03, B*13:01, DRB1* 04:06, DQB1* 03:02).
We wish to highlight the importance of specified voluntary stem cell donor data pools in India. There are independent stem cell registries operating from India, but the government should be actively involved in the streamlining of these individual data pools and the creation of a national stem cell registry. Considering divert Indian, a matched donor is most likely to be recovered amongst donors of same ethnicities and hence, clearly demonstrates the need for a larger specific diversified HLA MUD data pool in India to assist more number of similar needy patients.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Mishra VC, Tiwari AK, Raina V, Sharma G. Timelines, an important tool for matched unrelated donor stem cell transplant: A case report and review of literature. Indian J Transplant 2018;12:205-6. [Full text]
Tiercy JM. How to select the best available related or unrelated donor of hematopoietic stem cells? Haematologica 2016;101:680.
Mishra VC, Dorwal P, Solanki H, Kohli T, Tiwari AK, Raina V, et al
. Human leukocyte antigen-matched unrelated donor search experience for hematological disorder patients requiring transplant: Scenario for Indian patients. Indian J Med Paediatric Oncol 2019;40:32-4.
Tiwari AK, Bhati-Kushwaha H, Kukreja P, Mishra VC, Tyagi N, Sharma A, et al.
Probability of Finding Marrow Unrelated Donor (MUD) for an Indian patient in a Multi-national Human Leukocyte Antigen (HLA) Registry. Indian J Hematol Blood Transfus 2015;31:186-95.