Seven years of experience of preimplantation HLA typing: a clinical overview of 327 cycles

Preimplantation HLA typing for stem cell transplantation treatment of congenital and acquired bone marrow failures

“…Similar experience was reported from Turkey, where 236 PGD cycles were performed resulting in birth of 70 thalassemia-free children. Bone marrow transplantation led to successful bone marrow reconstitution in all but 4 cases [14,15]. completely replenishes the immune system, so PGD is an obvious alternative for inherited forms of SCID, to ensure the birth of unaffected children, who may then serve as a potential stem cell donor progeny for the affected siblings [11].…”

“…This resulted in a clinical pregnancy and birth of a healthy carrier of FANCC gene, whose umbilical cord blood was collected at birth and transplanted to the affected sibling, resulting in a successful hematopoietic reconstitution [2]. This world's first case has opened a new chapter in stem cell transplantation treatment of congenital and acquired diseases using the technology of preimnplantation HLA typing [6][7][8][9][10][11][12][13][14][15]. So the present paper describes the progress in PGD for HLA since the description of the above case, involving preimplantatgion HLA typing for a variety of congenital and acquired conditions, demonstrating that PGD has become an acceptable practical option for HLA matched stem cell transplantation treatment for inherited and sporadic bone marrow failures.…”

Recent advances in preimplantation genetic diagnosis

“…1 Moreover, PGD is an excellent option for families who have an affected child who is in need of bone marrow transplantation. Preimplantation HLA typing can facilitate the birth of an HLA-matched donor infant, 66,67 and hematopoietic progenitor cells from this donor could then be transplanted into the affected child with a successful cure as a result. 68 …”

Eleven years of preimplantation genetic diagnosis for human leukocyte antigen matching: is there room for improvement?

“…The women must respond well to hormonal stimulation to maximize the number of embryos available for diagnosis. Of note, outcomes tend to be poorer in this group of patients due to the often older maternal age, compared with patients undergoing routine fertility treatment [11]. Embryo quality is also important to ensure the best implantation potential, but there are still no certain methods to select the 'best' embryo(s).…”

“…The most common indication is PGD combined with exclusion of β-thalassemia and/or sickle-cell syndromes (~70% of cycles performed) [12]. The largest published series of PGD-HLA cycles reports 262 cycles combining HLA typing and disease exclusion and 62 cycles for HLA typing alone, reporting a 30-35% clinical pregnancy rate per embryo transfer, with 61 babies born and 21 children cured [11]. However, the outcomes of PGD-HLA reported by other groups vary, illustrating the unpredictability of overall success with the technique.…”