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Bone marrow donor registries: the relation between registry size and
probability of finding complete and partial matches [see comments]
FA Sonnenberg, MH Eckman and SG Pauker
Department of Medicine, New England Medical Center, Boston, MA 02111.
In a registry of volunteer bone marrow donors, the relation between
registry size and probability of finding an exact or partial match for a
random recipient cannot be theoretically derived because it depends on
specifics of the human leukocyte antigen (HLA) haplotype frequencies in the
donor and recipient populations. The relation must be explicitly calculated
using empirically determined HLA haplotype frequency data for all possible
pairings between a donor and a recipient population. This report describes
a general solution to this problem. The method shows that the relation of
the probability of matching to registry size is sigmoidal, with small
increases in probability at the extremes of registry size and a middle
range of registry size within which the probability of matching increases
most sharply. This range determines the approximate size of the most
cost-effective registry. In addition, for any pairing of donor and
recipient populations, there is a maximum probability of identifying a
match of a given quality for a random recipient, which cannot be exceeded
even if registry size were infinite. This upper limit is a function of the
frequency of blank (or unknown) alleles in the donor and recipient
populations; the higher that frequency, the lower the maximum probability
of achieving any given quality of match. The determinants of the
probability of achieving a given quality of match with a given registry
size are (1) the genetic heterogeneity within the recipient and donor
populations, which increases the registry size required to achieve a given
probability of matching, and (2) the degree of genetic homology between the
donor and recipient populations, which increases the maximum probability of
matching and also lowers registry size requirements. The method described
here can be used to estimate donor pool size requirements using any donor
and recipient populations for which HLA frequency data are available.
Volume 74,
Issue 7,
pp. 2569-2578,
11/15/1989
Copyright © 1989 by The American Society of Hematology
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