Research Projects of CNMDR

The CNMDR laboratories have actively participated in numerous research projects related to the development trends in the transplantation medicine.

1. Currently running projects
2. Finished projects and publications
3. IT projects for the development of the programme

1. Currently running projects

1. The Hematopoietic Cell Transplantation (HCT) component of the International Histocompatibility Working Group (IHWG).
   A long-term international multicentre project coordinated from the U.S.A. (Seattle) which continuously collects HLA data and clinical results of non-relative transplantations from the biggest transplantation centres and HLA laboratories from the whole world. The data serve for the research of the compatibility impact of HLA specific antigens on results of bone marrow transplantations. The HLA laboratory of CNMDR is the only participant in this project in the eastern and central Europe.
2. The need for and use of auto-transfusions for healthy donors at bone marrow donation
   The project monitoring the necessity to administer auto-transfusion after bone marrow donation in relation to other laboratory parameters of a donor; redefining the rules for collections and indication of auto-transfusions

2. Finished projects and publications

1. The analysis of KIR genes diversity of the A1B8DR3 (AH 8.1) haplotype in the Czech National Marrow Donors Registry (CNMDR) donors. The scenario for the donor selection according to KIR repertoire?
   An original CNMDR project examining the diversity of KIR gene repertoire in donors with most conserved AH 8.1 HLA haplotype and their potential importance for the strategy for the selection of the haematopoietic cell donors to clinical transplantations. In 2010 the results were published as an original thesis in the prestigious international magazine Tissue Antigens.
2. The Association of IL6 and CCL2 gene polymorphisms with the outcome of allogeneic haematopoietic stem cell transplantation
   An international multicentre project with the participation of three CR workplaces (the HLA laboratory of the Institute of Immunology of the Faculty Hospital Olomouc, the Central HLA laboratory of CNMDR in Pilsen and the Medical Faculty of the University of Palacky Olomouc) and a HLA laboratory in Slovenia. The project examined the importance of polymorphism of cytokines for clinical results of haematopoietic cell transplantations. The results were published as an original thesis in the prestigious international magazine Bone Marrow Transplantation.
3. Allogeneic transplant in patients aged over 50 years: are results from young unrelated donors comparable to those from older relatives?
   A multicentre project five transplantation centres in the Czech Republic and Slovak Republic participate in, besides CNMDR (Pilsen, Hradec Králové, Olomouc, Prague Královské Vinohrady and Bratislava). The thesis examines to what extent the results of haematopoietic cell transplantations from young non-relative donors differ from the results of transplantations with older siblings. Continuous results of the study were presented at international conferences of the European Group for Blood and Bone Marrow Transplantations and the European Federation for Immunogenetics in 2099 and they are prepared to be published in a professional magazine.
4. Evaluating registry serology by duplicate typing with a DNA-based method
   This was an international multicentre study evaluating the accuracy of serology HLA antigen typing by means of an independent duplicate DNA typing. In 2007 five selected registries from the whole world including CNMDR participated in the project. The purpose was to compare quality and general limitations of serology typing in individual registries. Upon the evaluation of the study at the beginning of 2008, rational arguments for the complete changeover to the DNA typing were obtained.

3. IT projects for the development of the programme

In close cooperation with the University of West Bohemia, a grant called “Research and Development of Advanced IT Technologies for the Support of Search of a Donor for Bone Marrow Transplantation" was entered for the Public Competition in Research, Development and Innovations declared in 2010 by the technological Agency of the Czech Republic which was completely accepted in 2010.

Within the grant, three basic areas of CNMDR work will be resolved or improved:

Donor search, calculation of match probability

1. General probability of 6/6 ABDR matching donor presence in CNMDR for a Czech patient
2. Probability for finding a 10/10 (9/10) donor in CNMDR for a Czech patient
3. For I+II simultaneous retrospective analysis of implemented searches
4. Probability for Cw* match with ABDR matching donors
5. Probability for DQB1* match with ABDR matching donors
6. Targeted analysis of balance-polymorphous allelic groups or “promiscuous” associations
   1. B*35, 44 *DRB1*04,11,13
   2. B*51-Cw*……B*18 –Cw* …..B*15-Cw*
7. Visualisation of results of questions IV-VI to “search” reports for the needs of transplantation centres
8. The update of search algorithms to reflect molecular-genetic data of donors, donor sorting by molecular-genetic typing results.

HLA genetic diversity of the registry - the evaluation of CNMDR data

1. How many unique HLA phenotypes (genotypes) does CNMDR contain in general?
2. How many new donors have to be recruited for 1 new unique HLA phenotype - the efficiency of the non-targeted recruitment?
3. Are there differences in the efficiency of non-targeted recruitment among individual DC = relative contribution of individual DC to the diversity of the registry.
4. Where (in which region) should recruitment be carried out preferably (where is the biggest chance for enriching the registry)?

Creation or “upgrade” of the electronic communication and all CNMDR databases

1. Create a uniform SW for DC CNMDR
2. Improve or newly establish the electronic connection between individual parts (DC-KC-TC) and databases of the registry
3. Create our own unique communication interface with EMDIS