Stem Cell Therapeutic Outcomes Database (Product Form)

Instructions for Confirmation of HLA Typing
Form 2005
All transplant centers (both TED-only and Comprehensive Report Form) must
complete the Form 2005 for all non-NMDP allogeneic or syngeneic donors, nonNMDP cord blood units, and recipients of non-NMDP products. If the donor was
secured through the NMDP, report the donor’s HLA typing on NMDP Form 22
(Confirmation of Donor HLA Typing) and the recipient’s HLA typing on NMDP
Form 117 (Final Recipient HLA Typing).
DNA technology can be used to type for a single allele, combinations of alleles
(allele strings), or a “generic” allele designation that is similar to a serologic
typing result. For this reason, the number of digits, as well as the number of
alleles for reporting will vary. Boxes are provided for reporting several possible
allele combinations for each allele at a locus. Laboratories may report results that
contain a combination of numbers and letters. The letters are called allele codes,
and will be 2-4 characters in length which represent a combination of possible
alleles at a locus. The laboratory may report allele combinations several different
ways (e.g., DRB1*0101 or 0102, DRB1*0101/0102 or DRB1*01AB). Report one
possible allele or allele code in each group of boxes, using as many groups of
boxes as there are alleles or allele codes to report. There will be two alleles
reported for each locus, unless the individual is presumed homozygous (i.e.,
carries two copies of the same allele) at a locus.
Generic typing, also known as low resolution typing, is similar to serologic typing
as it identifies broad families of alleles. This typing allows a preliminary view of
the likelihood of a match between recipient and donor, and is generally faster and
less expensive than high resolution typing.
To report a generic typing for one allele at a locus, which may be reported by
your laboratory as the locus followed by an asterisk then two digits (e.g., DRB1
*04), report “04XX,” and leave the other boxes blank.
For a glossary of terms used in this section of the manual, see appendix B.

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National Marrow Donor Program and The Medical College of Wisconsin
Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
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Confirmation of HLA Typing
CIBMTR Form 2005

Key Fields
For instructions regarding the completion of the Key Fields, see appendix K.
NOTE: Form 2005
A separate copy of this form must be completed for each recipient of a nonNMDP product and each non-NMDP donor and/or cord blood unit.
Question 1: Specify the person for whom this typing is being done?
Indicate the person whose HLA typing is reported on this form.
• If for the recipient, continue with question 5.
• If for the recipient’s mother, continue with question 2.
• If for the recipient’s father, continue with question 3.
• If for a non-NMDP donor, select “donor – confirmatory typing,” and
continue with question 5.
• If for a cord blood unit, continue with question 5.
• If for maternal HLA typing (typing of the mother of a cord blood unit),
continue with question 5.
• If for a person other than those listed, continue with question 4 and
specify the person’s relationship to the recipient.
• For all other responses, continue with question 5.
Question 2: Was the recipient’s mother used as the donor?
Check “yes” or “no” to indicate whether the recipient’s mother was used as the
donor. Continue with question 5.
Question 3: Was the recipient’s father used as the donor?
Check “yes” or “no” to indicate whether the recipient’s father was used as the
donor. Continue with question 5.
Question 4: Specify person and typing
Indicate the person represented and their HLA typing (confirmatory vs. final). The
“other, specify person” category should be used to report an individual that
cannot be classified under one of the other options listed, such as a relative of
the recipient who was typed but not selected as the donor (e.g., aunt, uncle,
cousin, etc.).
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National Marrow Donor Program and The Medical College of Wisconsin
Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
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CIBMTR Form 2005

HLA Typing by DNA Technology
Six sets of boxes are provided for reporting several possible alleles for each
allele at a locus. For laboratory reports that list more than six possible alleles,
use the following process:
• Paper form submission: List the remainder of the alleles in the space
above or below the boxes for that locus.
• FormsNet™2 application: Report as many alleles as the application
allows and submit a copy of laboratory report using the Log of
Appended Documents Form 2800.
Question 5: Is a copy of the laboratory report attached?
Attaching a copy of the laboratory report assists in HLA testing confirmation and
reduces the need for later data queries. If a copy of the laboratory report is
submitted with the form, check “yes” and complete the Log of Appended
Documents Form (Form 2800). For more information regarding the Form 2800,
see General Instructions, Log of Appended Documents.
NOTE: Questions 6-16
FormsNet 2 Application: There are two versions of questions 6-16 on the
Form 2005: one version for DNA typing, and one version for serologic typing. For
the purposes of this manual, the questions involving DNA typing will be labeled
6d-16d; the questions for serologic typing will be 6s-16s. Questions 6d-16d are
listed first, then questions 6s-16s.
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Paper Form Submission: Question numbering restarts with question 6 for
Serologic typing.
Class I
Question 6d: Locus A
Check either “one” or “two” to indicate the number of HLA-A alleles that were
tested by DNA-based methods. For First A*, report the allele designation for
HLA-A in the first set of boxes. Report a single allele, a string of alleles, or an
allele code. For Second A*, report the allele designation for HLA-A in the second
set of boxes. A set of boxes is considered the series of 36 boxes. If the person is
homozygous, leave the second set of boxes blank.
If HLA-A alleles were not tested, check “not tested” and continue with question
7d.
Question 7d: Locus B
Check either “one” or “two” to indicate the number of HLA-B alleles that were
tested by DNA-based methods. For First B*, report the allele designation for
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National Marrow Donor Program and The Medical College of Wisconsin
Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
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CIBMTR Form 2005

HLA-B in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second B*, report the allele designation for HLA-B in the second
set boxes. A set of boxes is considered the series of 36 boxes. If the person is
homozygous, leave the second set of boxes blank.
If HLA-B alleles were not tested, check “not tested” and continue with question
8d.
Question 8d: Locus C
Check either “one” or “two” to indicate the number of HLA-C alleles that were
tested by DNA-based methods. For First C*, report the allele designation for
HLA-C in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second C*, report the allele designation for HLA-C in the second
set boxes. A set of boxes is considered the series of 36 boxes. If the person is
homozygous, leave the second set of boxes blank.
If HLA-C alleles were not tested, check “not tested” and continue with question
9d.
Class II
Question 9d: Locus DRB1
Check either “one” or “two” to indicate the number of HLA-DRB1 alleles that were
tested by DNA-based methods. For First DRB1*, report the allele designation for
HLA-DRB1 in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second DRB1*, report the allele designation for HLA-DRB1 in
the second set boxes. A set of boxes is considered the series of 36 boxes. If the
person is homozygous, leave the second set of boxes blank.
If HLA-DRB1 alleles were not tested, check “not tested” and continue with
question 10d.
Class II (Optional)
Question 10d: Locus DRB3
Check either “one” or “two” to indicate the number of HLA-DRB3 alleles that were
tested by DNA-based methods. For First DRB3*, report the allele designation for
HLA-DRB3 in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second DRB3*, report the allele designation for HLA-DRB3 in
the second set boxes. A set of boxes is considered the series of 36 boxes. If the
person is homozygous, leave the second set of boxes blank.
If there were no HLA-DRB3 alleles, or the DRB3 alleles were not tested, check
“none” or “not tested” and continue with question 11d.
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National Marrow Donor Program and The Medical College of Wisconsin
Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
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Confirmation of HLA Typing
CIBMTR Form 2005

Question 11d: Locus DRB4
Check either “one” or “two” to indicate the number of HLA-DRB4 alleles that were
tested by DNA-based methods. For First DRB4*, report the allele designation for
HLA-DRB4 in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second DRB4*, report the allele designation for HLA-DRB4 in
the second set boxes. A set of boxes is considered the series of 36 boxes. If the
person is homozygous, leave the second set of boxes blank.
If there were no HLA-DRB4 alleles, or the DRB4 alleles were not tested, check
“none” or “not tested” and continue with question 12d.
Question 12d: Locus DRB5
Check either “one” or “two” to indicate the number of HLA-DRB5 alleles that were
tested by DNA-based methods. For First DRB5*, report the allele designation for
HLA-DRB5 in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second DRB5*, report the allele designation for HLA-DRB5 in
the second set boxes. A set of boxes is considered the series of 36 boxes. If the
person is homozygous, leave the second set of boxes blank.
If there were no HLA-DRB5 alleles, or the DRB5 alleles were not tested, check
“none” or “not tested” and continue with question 13d.
Question 13d: Locus DQB1
Check either “one” or “two” to indicate the number of HLA-DQB1 alleles that were
tested by DNA-based methods. For First DQB1*, report the allele designation for
HLA-DQB1 in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second DQB1*, report the allele designation for HLA-DQB1 in
the second set boxes. A set of boxes is considered the series of 36 boxes. If the
person is homozygous, leave the second set of boxes blank.
If there were no HLA-DQB1 alleles, leave the boxes blank and continue with
question 14d.
Question 14d: Locus DPB1
Check either “one” or “two” to indicate the number of HLA-DPB1 alleles that were
tested by DNA-based methods. For First DPB1*, report the allele designation for
HLA-DPB1 in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second DPB1*, report the allele designation for HLA-DPB1 in the
second set boxes. A set of boxes is considered the series of 36 boxes. If the
person is homozygous, leave the second set of boxes blank.
If there were no HLA-DPB1 alleles, leave the boxes blank and continue with
question 15d.

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Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
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Confirmation of HLA Typing
CIBMTR Form 2005

Question 15d: Locus DQA1
Check either “one” or “two” to indicate the number of HLA-DQA1 alleles that were
tested by DNA-based methods. For First DQA1*, report the allele designation for
HLA-DQA1 in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second DQA1*, report the allele designation for HLA-DQA1 in
the second set boxes. A set of boxes is considered the series of 36 boxes. If the
person is homozygous, leave the second set of boxes blank.
If there were no HLA-DQA1 alleles, leave the boxes blank and continue with
question 16d.
Question 16d: Locus DPA1
Check either “one” or “two” to indicate the number of HLA-DPA1 alleles that were
tested by DNA-based methods. For First DPA1*, report the allele designation for
HLA-DPA1 in the first set of boxes. Report a single allele, a string of alleles or an
allele code. For Second DPA1*, report the allele designation for HLA-DPA1 in the
second set boxes. A set of boxes is considered the series of 36 boxes. If the
person is homozygous, leave the second set of boxes blank.
If there were no HLA-DPA1 alleles, leave the boxes blank and continue with
question 17.

Antigens Defined by Serologic Typing
Use the lists provided to report antigens defined by serologic typing. Report
broad antigens only if the laboratory was not able to confirm typing for a known
split antigen.
A Antigens
Question 6s: Number of antigens provided
Indicate the number of HLA-A antigens tested by serology. If one antigen was
tested, report “one” and specify the appropriate antigen in the first column. If two
antigens were tested, report “two” and specify the first antigen in the first column,
and the second antigen in the second column.
If serologic testing was not performed, leave this section blank and continue with
question 7s.

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National Marrow Donor Program and The Medical College of Wisconsin
Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
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Confirmation of HLA Typing
CIBMTR Form 2005

B Antigens
Question 7s: Number of antigens provided
Indicate the number of HLA-B antigens tested by serology. If one antigen was
tested, report “one” and specify the appropriate antigen in the first column. If two
antigens were tested, report “two” and specify the first antigen in the first column,
and the second antigen in the second column.
If serology testing was not performed, leave this section blank and continue with
question 8s.
C Antigens
Question 8s: Number of antigens provided
Indicate the number of HLA-C antigens tested by serology. If one antigen was
tested, report “one” and specify the appropriate antigen in the first column. If two
antigens were tested, report “two” and specify the first antigen in the first column,
and the second antigen in the second column.
If serology testing was not performed, leave this section blank and continue with
question 9s.
Bw Specificity
Question 9s: Bw4
If the laboratory report indicates HLA-Bw4 as present, check “yes.” If the
laboratory report indicates no presence of HLA-Bw4, check “no.”
If serology testing was not performed, leave this section blank and continue with
question 10s.
Question 10s: Bw6
If the laboratory report indicates HLA-Bw6 as present, check “yes.” If the
laboratory report indicates no presence of HLA-Bw6, check “no.”
If serology testing was not performed, leave this section blank and continue with
question 11s.
DR Antigens
Question 11s: Number of antigens provided
Indicate the number of HLA-DR antigens tested by serology. If one antigen was
tested, report “one” and specify the appropriate antigen in the first column. If two
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National Marrow Donor Program and The Medical College of Wisconsin
Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
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Confirmation of HLA Typing
CIBMTR Form 2005

antigens were tested, report “two” and specify the first antigen in the first column,
and the second antigen in the second column.
If serology testing was not performed, leave this section blank and continue with
question 12s.
DR51 Antigen
Question 12s: DR51
If the laboratory report indicates DR51 as present, check “yes.” If the laboratory
report indicates no presence of DR51, check “no.”
If serology testing was not performed, leave this section blank and continue with
question 13s.
DR52 Antigen
Question 13s: DR52
If the laboratory report indicates DR52 as present, check “yes.” If the laboratory
report indicates no presence of DR52, check “no.”
If serology testing was not performed, leave this section blank and continue with
question 14s.
DR53 Antigen
Question 14s: DR53
If the laboratory report indicates DR53 as present, check “yes.” If the laboratory
report indicates no presence of DR53, check “no.”
If serology testing was not performed, leave this section blank and continue with
question 15s.
DQ Antigens
Question 15s: Number of antigens provided
Indicate the number of HLA-DQ antigens tested by serology. If one antigen was
tested, report “one” and specify the appropriate antigen in the first column. If two
antigens were tested, report “two” and specify the first antigen in the first column,
and the second antigen in the second column.
If serology testing was not performed, leave this section blank and continue with
question 16s.

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National Marrow Donor Program and The Medical College of Wisconsin
Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
Page 8 of 9

Confirmation of HLA Typing
CIBMTR Form 2005

DP Antigens
Question 16s: Number of antigens provided
Indicate the number of HLA-DP antigens tested by serology. If one antigen was
tested, report “one” and specify the appropriate antigen in the first column. If two
antigens were tested, report “two” and specify the first antigen in the first column,
and the second antigen in the second column.
If serology testing was not performed, leave this section blank and continue with
question 17.
Question 17: Contact information of person completing the form
Enter the name, phone number, fax number, and e-mail address of the person
completing the form.

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National Marrow Donor Program and The Medical College of Wisconsin
Document Title: CIBMTR Forms Manual: HLA Form 2005
Document Number: A00435 version 1
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