Nonpermissive HLA-DPB1 mismatch increases mortality after myeloablative unrelated allogeneic hematopoietic cell transplantation
| Autor: | Carlheinz Mueller, Alois Gratwohl, Adetola A. Kassim, Kwang Woo Ahn, Effie W. Petersdorf, Claudio Anasetti, Jason Dehn, Stephanie J. Lee, Hai-Lin Wang, Taiga Nishihori, Jan Storek, Ann E. Woolfrey, Stephen R. Spellman, Mahmoud Aljurf, Wael Saber, Marcelo A. Fernandez Viña, Joseph Pidala, Kirk R. Schultz, Medhat Askar, Vikas Gupta, Rabi Hanna, Mary M. Horowitz, William A. Wood, Yoshihiro Inamoto, Carolyn Katovich Hurley, James Robinson, Vinod K. Prasad, Bronwen E. Shaw, Machteld Oudshoorn |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Adolescent medicine.medical_treatment Immunology Graft vs Host Disease Hematopoietic stem cell transplantation Biology Biochemistry Young Adult Myelogenous Leukemia Myelogenous Chronic BCR-ABL Positive medicine Transplantation Homologous Humans Child HLA-DP beta-Chains Retrospective Studies Transplantation Leukemia Histocompatibility Testing Myelodysplastic syndromes Hematopoietic Stem Cell Transplantation Cell Biology Hematology Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease HLA Mismatch Histocompatibility Leukemia Myeloid Acute Myelodysplastic Syndromes Female Unrelated Donors Chronic myelogenous leukemia |
| Zdroj: | Blood. 124:2596-2606 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | We examined current outcomes of unrelated donor allogeneic hematopoietic cell transplantation (HCT) to determine the clinical implications of donor-recipient HLA matching. Adult and pediatric patients who had first undergone myeloablative-unrelated bone marrow or peripheral blood HCT for acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome between 1999 and 2011 were included. All had high-resolution typing for HLA-A, -B, -C, and -DRB1. Of the total (n = 8003), cases were 8/8 (n = 5449), 7/8 (n = 2071), or 6/8 (n = 483) matched. HLA mismatch (6-7/8) conferred significantly increased risk for grades II to IV and III to IV acute graft vs host disease (GVHD), chronic GVHD, transplant-related mortality (TRM), and overall mortality compared with HLA-matched cases (8/8). Type (allele/antigen) and locus (HLA-A, -B, -C, and -DRB1) of mismatch were not associated with overall mortality. Among 8/8 matched cases, HLA-DPB1 and -DQB1 mismatch resulted in increased acute GVHD, and HLA-DPB1 mismatch had decreased relapse. Nonpermissive HLA-DPB1 allele mismatch was associated with higher TRM compared with permissive HLA-DPB1 mismatch or HLA-DPB1 match and increased overall mortality compared with permissive HLA-DPB1 mismatch in 8/8 (and 10/10) matched cases. Full matching at HLA-A, -B, -C, and -DRB1 is required for optimal unrelated donor HCT survival, and avoidance of nonpermissive HLA-DPB1 mismatches in otherwise HLA-matched pairs is indicated. |
| Databáze: | OpenAIRE |
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