Preimplantation HLA (Human Lymphocyte Antigen) Testing
| Autor: | Yury Verlinsky, Mohammed Taranissi, Svetlana Rechitsky, Anver Kuliev, Randy Morris, T Sharapova |
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| Rok vydání: | 2004 |
| Předmět: |
Pregnancy
In vitro fertilisation business.industry medicine.medical_treatment Obstetrics and Gynecology Prenatal diagnosis Context (language use) General Medicine Human leukocyte antigen Preimplantation genetic diagnosis medicine.disease Transplantation Andrology Immunology Medicine Sibling business |
| Zdroj: | Obstetrical & Gynecological Survey. 59:703-705 |
| ISSN: | 0029-7828 |
| Popis: | When couples reject termination of a genetically affected pregnancy that has been identified by traditional prenatal diagnosis, preimplantation genetic diagnosis (PGD) is an alternative option. PGD, based on ovarian stimulation and in vitro fertilization (IVF), permits the selection of unaffected embryos before pregnancy begins. The procedure has other applications such as human lymphocyte antigen (HLA) matching to affected siblings so as to make stem cell transplantation possible. The investigators carried out HLA matching in the context of an IVF program for 9 couples whose children had acute lymphoid leukemia, acute myeloid leukemia, or Diamond-Blackfan anemia. In 13 clinical cycles, after removing single blastomeres from 8-cell embryos after IVF, DNA was analyzed for HLA genes as well as for short tandem repeats in the HLA region. In each case, 2 or 3 embryos found to be HLA-compatible with the affected sibling then were transferred. In all, 199 embryos were tested for the 9 couples, averaging 15 embryos per cycle. Of these, 45 (23%) were HLA-matched to affected siblings. With 1 exception, the HLA-matched embryos were available for transfer. Twenty-eight matched embryos were transferred in 12 clinical cycles, resulting in 5 singleton pregnancies (42%) and the birth of 5 HLA-matched children. All 5 children were healthy when assessed at a mean age of approximately 12 months. The mean birth weight and birth length percentiles were 47% and 57%, respectively. One sibling with Diamond-Blackfan anemia underwent transplantation and no longer requires red cell transfusions. The other children are either preparing for transplantation or are in remission. Preimplantation HLA matching appears to be feasible for couples whose child has a bone marrow disorder and who may want another, HLA-matched child who could donate stem cells for transplantation to the affected sibling. This procedure, as a complement to traditional prenatal diagnosis, might prove applicable to other types of cancer. It permits parents to avoid having a child with an inherited disorder and thereby may avoid the need to terminate pregnancy. |
| Databáze: | OpenAIRE |
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