Early HLA Typing for Improved Patient Outcomes

HLA Today offers critical information early in a patient’s disease course

For patients newly diagnosed with a condition for which allogeneic hematopoietic cell transplantation (HCT) may be indicated, human leukocyte antigen (HLA) typing along with cytogenetic testing is critical at the time of diagnosis. This allows the process for finding a related or unrelated donor to begin as early as possible, even before your patient has a transplant consultation.

Our free HLA Today program removes barriers to patient and family member HLA typing at diagnosis.

There is no cost to you, your patient or their family members, and no insurance paperwork to file.

Explore the following sections. Then contact us to get started.

• How HLA today supports your treatment decision-making for your patient
• How to get started with HLA Today in your hematology/oncology practice
• How to request HLA typing for family members
• Early HLA typing allows barriers to HCT to be addressed sooner
• Research shows clinical benefit of early HLA typing
• Additional resources for clinicians and your patients
• Frequently asked questions
• Request HLA Today kits

How HLA Today supports your treatment decision-making for your patient

We’re offering HLA Today to hematologists/oncologists because research has shown you can increase the likelihood your patient will have better treatment outcomes by conducting HLA typing and cytogenetic testing at the time of diagnosis.¹

When these standards of care are followed, patients are more likely to have HCT in early stage disease. Studies on HCT have revealed that patients who receive transplant in earlier disease stages have better outcomes than those transplanted in more advanced disease stages.²

Through HLA Today, you’ll receive not only your patient’s HLA typing information. You’ll also receive a preliminary search report on unrelated donor matches from Be The Match Registry®. In addition, you can request HLA typing of relatives.

When you have all of this information early, you have the information you need to make the best treatment decisions for your patients. For appropriate patients, consultation at a transplant center can happen promptly.

How to get started with HLA Today in your hematology/oncology practice

Getting started with HLA Today is easy. You place an order for free buccal swab kits from our team at the National Marrow Donor Program® (NMDP)/Be The Match®. We deliver the kits to your hematology/oncology practice so you have them available for newly diagnosed patients.

You use a buccal swab kit to gently collect genetic material from your patient’s cheek at the time of diagnosis. Then you send the completed kit to the NMDP/Be The Match.

You can also request free HLA typing for family members. Because the NMDP/Be The Match is covering the cost of the program for patients and their relatives, you do not need to file insurance paperwork or wait for approvals for HLA typing.

We conduct your patient’s high-resolution HLA typing at the same laboratory that performs HLA typing for our NMDP/Be The Match donors.

In seven to 10 days, you’ll receive an email that includes:

• Your patient’s high-resolution HLA typing
• Your patient’s search prognosis, which is the likelihood your patient will have a fully matched unrelated donor on Be The Match Registry
• A preliminary search report that includes the number of adult unrelated donor or cord blood units that match your patient
• Information on the transplant centers nearest to you

If you request family member intermediate-resolution HLA typing, you will receive those results separately.

You’ll use the information to make critical treatment decisions with your patient as early as possible. No matter the search report prognosis, we encourage you to consult with a transplant center as early as possible.

Early referral allows barriers to HCT to be addressed sooner. A transplant center can help you and your patient explore all treatment options beyond fully matched related or unrelated donors.

How to request HLA typing for family members

When you conduct family member HLA typing at the time of your patient’s diagnosis, you’ll know right away if your patient has a related donor match. This can help you and the transplant center make treatment decisions.

The service includes shipment of a buccal swab kit to selected family members and intermediate resolution HLA typing. The family members you choose for typing will receive a buccal swab kit with instructions on swabbing and returning the kit.

Because the kit must be mailed to the family member and returned to the lab for testing, you will receive a separate email with the typing results.

To request family member HLA typing through HLA today, email the following information to HLAToday@nmdp.org:

Patient Information

Name:
Date of birth:

Family Member Information

Name:
Relationship to patient:
Date of birth:
Shipping address:
Phone number:
Email address:

Selecting family members for HLA typing

When selecting family members for HLA typing, remember the following relatives are most likely to be selected by a transplant center as a fully matched or haploidentical related donor:

• Full siblings (highest likelihood of being a full match)
• Half siblings
• Biological parents
• Biological children

Hematopoietic stem cell donors must be in generally good health with no chronic illnesses that are severe or not well-managed and no whole-body autoimmune diseases.

Early HLA typing allows barriers to HCT to be addressed sooner

When HLA typing occurs at diagnosis, the process of finding an HLA matched related or unrelated donor for allogeneic hematopoietic stem cell transplantation can start early. This is important because finding a suitable donor can take time, especially if the preliminary search report shows a patient has an HLA type not commonly found on the registry.

If your patient does not have a fully matched related donor, unrelated donor or cord blood unit available, early HLA typing also allows the transplant center to evaluate alternative options. This could include a donor with a lower degree of HLA match or a haploidentical related donor.

Starting the donor search early can increase the likelihood your patient can undergo transplant at the optimal time.

In addition, your patient’s care team will have more time to address any non-immunologic barriers to transplant. For example, issues with insurance or caregiver support.

The NMDP/Be The Match offers a number of services for patients—including financial assistance and clinical trial search support—to help patients overcome obstacles to transplant.

Research shows clinical benefit of early HLA typing

The HLA Today program is based on the results of the SWOG 1203 study of high-risk adult patients with AML. The researchers used a disciplined, organized process for early HLA typing and cytogenetic testing, rapid donor identification, and early referral for HCT.

In the study, hematologists/oncologists expedited HLA typing for all patients with high-risk cytogenetics at the time of diagnosis. Early cytogenetic testing and HLA typing allowed for earlier initiation of donor identification and referral for HCT consultation, which led to:

• 65% transplant rate in CR1 compared to the historical rate of 40% (p <0.001)
• 37% increase in 2-year overall survival among patients who underwent transplantation compared with patients who did not undergo transplantation (48% vs 35%, respectively p=0.031)

Researchers concluded that better outcomes in poor prognosis patients with AML may be achieved by initiating the process to find family member or unrelated donors at the time of diagnosis and performing HCT consistently in CR1.¹

Additional resources for clinicians

Considerations for HCT consultation

Advances in HCT now permit older adults with selected comorbidities and good functional status to safely undergo HCT for curative intent with a relatively low and acceptable risk of non-relapse mortality. Therefore, the consideration of HCT primarily includes patient and disease characteristics, not age alone.

Delays in referral can reduce success rates for transplant. There may be a narrow window of opportunity to proceed to transplant and delays might preclude transplant altogether.

The NMDP/Be The Match and the American Society for Transplantation and Cellular Therapy (ASTCT) jointly developed guidelines identifying appropriate timing of consultation for autologous or allogeneic HCT based on disease characteristics. The guidelines are based on current clinical practice, medical literature, National Comprehensive Cancer Network® (NCCN®) Guidelines for the treatment of cancer, and evidence-based reviews.

The referral timing guidelines are available as a free mobile app download, online or as a PDF. Access the referral timing guidelines.

Post-transplant care resources available for clinicians

After your patient leaves the transplant center and returns to your care, your support is critical to their long-term recovery and survival.

To help you deliver the specialized care your patient needs, we offer a three-part post-transplant care guide. We developed the guide in partnership with leading transplant organizations and based on peer-reviewed publications.

The guide includes:

• Recommended post-transplant screening and preventive practices to be used at a patient’s six-month, one-year and annual appointments
• Recommended immunization schedule to be consulted prior to a patient’s six-month appointment and as needed at future appointments
• Chronic graft-versus-host disease (GVHD) guide, which identifies clinical manifestations and symptoms of chronic GVHD along with a photo atlas

The post-transplant care recommendations are available as a free mobile app download, online or as a PDF. Access the post-transplant care recommendations.

Pre- and post-HCT education and financial resources for patients

When you are discussing treatment options with your patient, they may have questions about allogeneic stem cell transplantation. They might have concerns about paying for transplant. They may be wondering about what life is like after transplant.

We offer free resources for you to use with your patient and their family. We also offer financial assistance to support patients before and after transplant, as well as one-on-one support.

Find additional information on available patient resources and support and patient financial assistance.

Frequently asked questions

References

1. Pagel JM, Othus M, Garcia-Manero G, et al. Rapid Donor Identification Improves Survival in High-Risk First-Remission Patients With Acute Myeloid Leukemia. JCO Oncology Practice 2020; 16:6, e464-e475. Access.
2. 2. Pidala J, Lee SJ, Ahn KW, et al. Nonpermissive HLA-DPB1 mismatch increases mortality after myeloablative unrelated allogeneic hematopoietic cell transplantation. Blood. 2014; 124(16): 2596-2606. Access.
3. 3. National Comprehensive Cancer Network (NCCN®). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Access.

Request HLA Today kits

To request HLA Today swab kits or to receive more information about the program, fill out the form below. You can also contact us directly at HLAToday@nmdp.org.

For family member typing, email HLAToday@nmdp.org. Include the contact information found in the How to request HLA typing for family members section.

To request HLA Today swab kits or to receive more information about the program, fill out the form below. You can also contact us directly at HLAToday@nmdp.org.