A comparison of serological, cellular and DNA-RFLP methods for HLA matching in the selection of related bone marrow donors.

Serological, cellular and DNA-RFLP (restriction fragment length polymorphism) methods of determining HLA compatibility between 10 leukaemic patients and potential related bone marrow donors were systematically compared. DR beta/DQ alpha/DQ beta/DNA-RFLP typing of these families gave results in agreement with those obtained by serological methods (matching for HLA-A, -B and -DR), supported by mixed lymphocyte culture (MLC) data, indicating the validity and accuracy of DNA-RFLP matching in transplantation. However, a significant minority of four leukaemic patients plus two healthy individuals were not clearly HLA-DR typable by serology, but all such individuals were easily typable by DNA-RFLP. These results were supported by MLC data, where available. In addition, all data were in agreement with previously reported correlations between DNA-RFLPs and HLA-DR serology, allowing unambiguous assignment of HLA-DR types where these were previously in doubt. These results demonstrate the value of DNA-RFLP HLA class II DR and DQ typing in leukaemic patients requiring marrow transplantation who are not clearly typable by traditional methods and suggest that this approach should constitute an important element of future HLA matching programmes for bone marrow transplantation.