ABSTRACT

This chapter will review recent advances in our knowledge of the human leukocyte antigen (HLA) system and its clinical significance in bone-marrow transplantation (BMT). The use of unrelated donor bone-marrow transplants has shown how unpredictable the results can be, and has led to further efforts to try to clarify how we may select more suitable donors. Mismatched family donors with only one HLA locus mismatch result in a generally favourable outcome compared to unrelated donor transplants, and such transplants provide an excellent model for the study of the significance of specific mismatches. Firstly, we will introduce the ‘contemporary’ major histocompatibility complex (MHC) and the subsequent section will discuss latest typing techniques and their relevance to BMT.