Mapping the hla frequencies of donor registry in quebec to define a better recruitment strategy

Aim Hema-Quebec enrolls between 3000 and 4000 new stem cell donors in its registry every year with the ultimate goal of finding a stem cell donor inside Quebec province for 30–40% of our patients. However, we are very far from this goal with less than 4% of our patients finding a donor from the Quebec registry. In response to this, we analysed our donor population with the intention of reorienting our donor recruitment strategy. We wanted to identify the regions which are under-represented in term of donor numbers and haplotypes, since our population has geographical particularities that should be taken into account for recruitment strategy. Methods The HLA-A, -B and -DRB1 molecular typing available for almost 13,000 stem cell registry donors from Quebec were analyzed, using postal codes, for their geographic location. Data from low resolution for HLA-A and -B and intermediate resolution for HLA-DRB1 were pre-processed and analyzed using GENE[RATE] and additional tools. Hardy-Weinberg equilibrium (HWE) was assessed using a nested likelihood procedure. Reynolds’ genetic distances were computed between regions and plotted by PCoA. SAMOVA analyses were performed to identify possible genetic boundaries across Quebec. In parallel, patients with a difficult search over the last few years were analyzed. Patient and donor distributions in the different regions were evaluated in order to identify the need for active recruitment. Results Globally, the Hema-Quebec stem cell donor registry is mostly Caucasian, although the ethnicity of Montreal region, the biggest city of the province, is reaching more than 50%. In the other administrative regions, ethnicity is much lower. Estimation of the genetic distance between the different regions of Quebec shows that some regions like Saguenay and Gaspesie are clearly differentiated from the others based on their HLA content. These regions however, are much less represented in the registry as compared to Montreal, Laval and Quebec City regions. A recruitment strategy was design to overcome the lack of donors in particular regions. Conclusion By targeting the different regions of Quebec, the recruitment of donors should increase the representation of local haplotypes and improve the content of the Hema-Quebec stem cell donor registry in response to the need of our patients.