Effects of Haplotype Matching on Outcomes after Adult Single-Cord Blood Transplantation
| Autor: | Toru Sakura, Satoko Morishima, Junya Kanda, Makoto Onizuka, Naoyuki Uchida, Hikaru Kobayashi, Junji Tanaka, Takakazu Kawase, Koji Nagafuji, Hidenori Tanaka, Yoshiko Matsuhashi, Hiroto Kojima, Shigesaburo Miyakoshi, Yasuo Morishima, Tetsuya Eto, Satoshi Takahashi, Tatsuo Ichinohe, Yoshiko Atsuta, Takanori Ohta |
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| Rok vydání: | 2020 |
| Předmět: |
Transplantation
medicine.medical_specialty Matching (statistics) Neutrophil Engraftment Multivariate analysis Platelet Engraftment business.industry Haplotype Hazard ratio Hematology Disease 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine Cord blood medicine business 030215 immunology |
| Zdroj: | Biology of Blood and Marrow Transplantation. 26:509-518 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2019.09.035 |
| Popis: | It remains unclear whether the HLA haplotype of unrelated cord blood (UCB) should be matched to that of the patient in single UCB transplantation. Thus, using data from a Japanese registry, we analyzed the effect of haplotype matching on outcomes. Patients with hematologic diseases aged 16 years or older who had undergone their first transplant were included (N = 1347). The effects of haplotype matching and high-frequency HLA haplotype on outcomes were analyzed. Median patient age was 55 years. The cumulative incidences of neutrophil engraftment among groups with 0, 1, and 2 HLA haplotype matches were 79%, 82%, and 88%, respectively (P = .008). In a multivariate analysis, the group with 0 haplotype matches was marginally associated with worse neutrophil engraftment (P = .087) and significantly associated with platelet engraftment (P = .044) compared with the group with 1 haplotype match. Two-haplotype matches were associated with a higher risk of relapse. In the group with 1 haplotype match, the top 3 shared haplotypes were "A*24:02-B*52:01-C*12:02-DRB1*15:02" (HP-P1), "A*33:03-B*44:03-C*14:03-DRB1*13:02" (HP-P2), and "A*24:02-B*07:02-C*07:02-DRB1*01:01" (HP-P3). The presence of HP-P2 but not HP-P1 or HP-P3 was associated with a decreased risk of grades II to IV acute graft-versus-host disease (hazard ratio, .56; P = .001) but an increased risk of relapse (hazard ratio, 1.35; P = .045). HLA haplotype matching might be considered to improve engraftment. Two-haplotype matches should be avoided if the relapse risk is high. The haplotype itself may have an effect on the risk of acute graft-versus-host disease and relapse. |
| Databáze: | OpenAIRE |
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