Acceptable HLA-mismatching in unrelated donor bone marrow transplantation for patients with acquired severe aplastic anemia
| Autor: | Seiji Kojima, Hiroshi Yagasaki, Hisato Kigasawa, Koji Kato, Yoshihisa Kodera, Hisashi Sakamaki, Takakazu Kawase, Yasuo Morishima, Shunichi Kato, Hiromasa Yabe, Masahiro Tsuchida |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Bone marrow transplantation Immunology Human leukocyte antigen Multiple alleles Severity of Illness Index Biochemistry Gastroenterology Young Adult HLA Antigens Unrelated Donor Internal medicine medicine Humans Sibling Relations Significant risk Allele Child HLA-DP beta-Chains Bone Marrow Transplantation business.industry Histocompatibility Testing Infant Newborn Anemia Aplastic Infant Cell Biology Hematology Middle Aged Severe Aplastic Anemia Tissue Donors Molecular Typing Transplantation Child Preschool Female business |
| Zdroj: | Blood. 118:3186-3190 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | We retrospectively analyzed the effect of HLA mismatching (HLA-A, -B, -C, -DRB1, -DQB1) with molecular typing on transplantation outcome for 301 patients with acquired severe aplastic anemia (SAA) who received an unrelated BM transplant through the Japan Marrow Donor Program. Additional effect of HLA-DPB1 mismatching was analyzed for 10 of 10 or 9 of 10 HLA allele-matched pairs (n = 169). Of the 301 recipient/donor pairs, 101 (33.6%) were completely matched at 10 of 10 alleles, 69 (23%) were mismatched at 1 allele, and 131 (43.5%) were mismatched at ≥ 2 alleles. Subjects were classified into 5 subgroups: complete match group (group I); single-allele mismatch group (groups II and III); multiple alleles restricted to HLA-C, -DRB1, and -DQB1 mismatch group (group IV); and others (group V). Multivariate analysis indicated that only HLA disparity of group V was a significant risk factor for poor survival and grade II-IV acute GVHD. HLA-DPB1 mismatching was not associated with any clinical outcome. We recommend the use of an HLA 10 of 10 allele-matched unrelated donor. However, if such a donor is not available, any single-allele or multiple-allele (HLA-C, -DRB1, -DQB1) mismatched donor is acceptable as an unrelated donor for patients with severe aplastic anemia. |
| Databáze: | OpenAIRE |
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