Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Discrepancies between Human Leukocyte Antigen Registry Typing and Confirmatory Typing Results of Unrelated Hematopoietic Stem Cell Donors

  • Ko, Dae-Hyun (Department of Laboratory Medicine, Seoul National University College of Medicine) ;
  • Chung, Hye-Yoon (Department of Laboratory Medicine, Seoul National University College of Medicine) ;
  • Lim, Young-Mi (Department of Laboratory Medicine, Seoul National University College of Medicine) ;
  • Han, Bok-Youn (Department of Laboratory Medicine, Seoul National University College of Medicine) ;
  • Song, Eun-Young (Department of Laboratory Medicine, Seoul National University College of Medicine) ;
  • Park, Myoung-Hee (Department of Laboratory Medicine, Seoul National University College of Medicine)
  • Received : 2010.05.31
  • Accepted : 2010.10.14
  • Published : 2010.12.01
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Abstract

Background : In unrelated hematopoietic stem cell transplantation, the accuracy of HLA registry typing (RT) of donors is important for timely search and coordination of HLA-matched donors. We analyzed discrepancies between HLA RT and confirmatory typing (CT) results of stem cell donors in Korean and foreign registries. Methods : We analyzed the HLA typing results of 834 donors for whom CT was performed at Seoul National University Hospital between April 1997 and March 2010. For CT, DNA typing was used in majority of the cases and HLA-A and HLA-B serological typing was used in some early cases. The discrepancies between the typing results were analyzed at the serological/generic level. Results : The overall discrepancy rate (RT error rate) was 3.2%, and the rate was similar in the Korean and foreign registries. The discrepancy rates in the Korean and foreign registries were more than 10% in the 1997-2001 searches, but decreased to less than 3% in the 2002-2010 searches. Analysis of 19 cases of RT errors in the Korean registry revealed 3 cases of sample switchover errors and 16 cases of typing errors in one of the HLA-A, HLA-B, or HLA-DR loci. The RT error rate in Japan Marrow Donor Program was lower than those in other foreign registries. Conclusions : The error rate of HLA RT results of unrelated stem cell donors in the Korean registry was similar to those in the foreign registries, and has decreased in the recent searches following the change in the typing method from serological to DNA typing.

배경 : 비혈연 조혈모세포이식에 있어서 HLA 형별이 일치하는 기증희망자를 찾는 것은 매우 중요하며, 이런 점에서 기증희망자의 등록 시에 HLA 형별검사를 정확히 해야 기증희망자를 빠르게 찾아 일치하는 기증자를 찾을 수 있다. 저자들은 한국과 외국 기증희망자의 검색 과정에서 HLA 확인검사를 통해 등록검사 결과와 확인검사 결과의 불일치(등록검사 오류)에 대해 분석해보았다. 방법 : 1997년 4월부터 2010년 3월까지 서울대학교병원에서 HLA 확인검사를 실시한 834명의 기증희망자를 대상으로 하였다. 확인검사는 HLA-A, B 검사 중 초기의 일부는 혈청학적 방법으로 시행하였고, 그 외에는 DNA 검사를 실시하여 혈청학적(serological/generic) 수준에서의 불일치를 분석하였다. 결과 : 전체 불일치율(등록검사 오류율)은 3.2% (27/834)였고, 국내(3.1%, 19/610)와 국외(3.6%, 8/224) 기증희망자에서 오류율은 비슷하였다. 1997-2001년 검색에서 불일치율은 10% 이상이었으나(국내 13.3%, 국외 10.0%), 2002-2010년 검색에서는 3% 이하로 감소하였다(국내 2.6%, 국외 2.9%). 국내 기증희망자에서 발견된 19건의 오류를 분석해보았을 때, 검체가 바뀐 오류는 3건이 있었고, 검사 오류는 HLA-A, HLA-B, HLA-DR에서 각각 6건, 6건, 4건의 오류가 발생하였다. 외국 골수은행 중에는 일본 골수은행(Japan Marrow Donor Program, JMDP)의 오류율(1.5%)이 미국 골수은행(National Marrow Donor Program, NMDP) (8.1%)나 대만 골수은행(Buddhist Tzu Chi Stem Cells Center, BTCSCC) (7.1%)에 비해 낮은 경향을 보였다. 결론 : 비혈연 조혈모세포이식 기증희망자의 HLA 등록검사의 오류율은 국내와 국외에서 비슷하였다. 그리고 대부분의 기관에서 혈청학적 검사에서 DNA 검사로 방법을 전환함에 따라 오류율은 감소하고 있다.

Keywords

References

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