Stem cell transplantation is a recognized treatment for many hematologic malignancies. Human leukocyte antigen (HLA) testing is a key assessment in the evaluation of potential recipients and selection of the appropriate stem cell donor. Over the past several years, technological advances have moved HLA testing from a serologic art form to a sophisticated and high-resolution molecular-based procedure. HLA typing is now performed by DNA-based methods, while flow cytometry has significantly improved our ability to detect HLA antibodies. Although DNA-based typing methods have advanced our understanding of HLA polymorphisms, HLA antibodies still play a role in both stem cell and solid organ transplantation and can lead to failed engraftment or allograft graft rejection, respectively. Flow cytometric crossmatching and HLA antigen-specific microparticle assays represent the new HLA serology. Together, these new technologies are impacting patient outcomes and are expanding our understanding of the immune response to HLA alloantigens. Semin Hematol 38:194-200.
Copyright 2001 by W.B. Saunders Company.