Completing the CIBMTR Confirmation of HLA Typing form Form 2005

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Completing the CIBMTR Confirmation of HLA Typing
form (Form 2005)
Steve SpellmanResearch Manager, Scientific
Services Maria Brown Scientific Services
Specialist
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Outline

• Introduction to Form 2005
• Overview of HLA nomenclature
• Laboratory report interpretation and data
  transcription

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Introduction

• The CIBMTR product information is collected on
  three separate forms
• The IDM form (Form 2004)
• The Confirmation of HLA Typing form (Form 2005)
• Infusion form (Form 2006)
• HLA form modeled on NMDP Form 22/117

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Confirmation of HLA Typing Form

• The Confirmation of HLA Typing form is completed
  for
• Non-NMDP allogeneic or syngeneic donors
• Non-NMDP recipients
• Non-NMDP cord blood units
• Complete a separate copy of this form for each
  donor, recipient, or cord blood unit
• Not required on NMDP facilitated transplants!

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FormsNet 2.0
All data fields identical to the paper form.
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Overview of HLA Nomenclature
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HLA Nomenclature
Serology
DNA
A0201 A2 A0202 A2 A0203
A2 A0204 A2 A0205 A2
A0273 A2
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Examples of Serological TypingNomenclature
order of antigen discovery
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Examples of DNA Typing Nomenclature
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DNA NomenclatureSilent Substitutions

• DRB1150201 DRB1150202
  DRB1150203 DRB1150204
• The fifth sixth digits indicate a difference in
  DNA structure, but the HLA antigens specified do
  not differ

Example DRB11502
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DNA Nomenclature Oddities

• A020101 Silent mutation
• A2409N (Null) No antigen expressed
• A2402L Low antigen expression
• B4402S HLA protein is secreted
• B3565Q antigen level is questionable

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NMDP Allele Codes used for Multiple Allele
Designations

• Used to report multiple possible alleles
  (intermediate/high resolution)
• Provides maximum information on the persons
  typing
• NMDP Bioinformatics Web site contains look-up Web
  tool
• www.bioinformatics.nmdp.org

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NMDP Codes for Multiple Allele Designation
AB 01/02

• A0201 or 0202 A02AB
• B4001 or 4002 B40AB
• DRB11501 or 1502 DRB115AB

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CIBMTR Confirmation of HLA Typing form (Form 2005)
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Key Fields Box

• The Key Fields Box contains information about the
  transplant recipient, donor, cord, transplant
  date and type of transplant.
• The Key Fields link the donor forms to the
  patient forms.

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Key Fields Box
The section on the bottom of Page 5 is used if
multiple donors or cords were infused into one
recipient.
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Whos HLA typing data are you reporting?
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Are you submitting a laboratory report?

• If you have any questions about how to interpret
  a lab report, please contact either
• Maria Brown 612/627-8186 (mbrown2_at_nmdp.org)
• Steve Spellman 612/617-8334 (sspellma_at_nmdp.org)

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Transcribing HLA Typing Data from Laboratory
Reports
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General Instructions DNA Typing

• One possible allele in each set of boxes
• Use as many boxes as you have alleles to report
• If more than six possible alleles, fill the
  boxes provided then write the remainder of the
  alleles in the available space on the page
  clearly indicating the appropriate locus.

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DNA-Based Typing
Labs have different reporting formats This
example stacks the antigen typing.
A1 B1 A2 B2 Notice that the leading
allele group is dropped (0209, 0243N etc). Data
may be submitted as written or as shown.
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DNA-Based Typing in FormsNet

• The HLA field in FormsNet supports up to 250
  characters
• A / is used to separate alleles (example to
  right or 0702/0744) either way is acceptable
• A - may be used to indicate a range of alleles
  (example 0101-0103 equals 0101/0102/0103)

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Which Typing do I use?
Patient
Donor
Remember to check the comments or footnotes on
your laboratory report. There is often further
clarification of the HLA typing.
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What About Symbols _at_!
Laboratory Report
_at_ C0701/0706/0718 NT Not Tested
Enter the alpha/numeric data from the footnote on
the forms and/or into FormsNet 2.0. Please note
that without the key we cannot decipher your
symbols.
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Reporting NMDP Allele Codes
Directly transcribe any allele codes onto the
form or into FormsNet.
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What to do with Positives??
Example
Either write or type positive or pos Please
do not use or -
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Serologic Typing and DNA?ENTER BOTH!
Serology
DNA
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Serology in FormsNet 2.0
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Summary

• Form 2005 required on Non-NMDP donors and
  recipients
• Multiple donors multiple forms
• Transcribe data directly as reported on
  laboratory report
• Remember to watch for footnotes
• Include all possible alleles for DNA-based typing
• Report both DNA and Serology data, if available

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• Please remember
• If you have any questions about how to interpret
  a lab report, please contact either
• Maria Brown 612/627-8186 (mbrown2_at_nmdp.org)
• Steve Spellman 612/617-8334 (sspellma_at_nmdp.org)