HLA-matched sibling transplantation for severe aplastic anemia: impact of HLA DR15 antigen status on engraftment, graft-versus-host disease, and overall survival. Biol Blood Marrow Transplant 2012 Sep;18(9):1401-6
Date
03/06/2012Pubmed ID
22387349Pubmed Central ID
PMC3406237DOI
10.1016/j.bbmt.2012.02.007Scopus ID
2-s2.0-84865157149 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
The HLA class II DRB1 antigen DR15 (common alleles *1501, *1502) is an important marker in the pathobiology of severe aplastic anemia (SAA). We studied 1204 recipients of HLA-matched sibling bone marrow transplantation for SAA to determine whether HLA DR15 status (as determined by allele-level typing) affected hematopoietic recovery, graft-versus-host disease (GVHD), or overall survival (OS). In multivariate analysis, secondary graft failure rate at 2 years was lower in patients who were HLA DR15+ (hazard ratio = 0.46, P = .01). However, neutrophil recovery at day -28, platelet recovery at day -100, acute GVHD, chronic GVHD, and overall mortality were independent of DR15 status. The 5-year probabilities of OS, after adjusting for age, race, performance score, transplant-conditioning regimen, and year of transplantation, were 78% and 81% for patients who were HLA DR15+ and HLA DR15-, respectively (P = .35). In conclusion, DR15 status is associated with secondary graft failure after HLA-matched sibling bone marrow transplantation for SAA but has no significant impact on survival.
Author List
Battiwalla M, Wang T, Carreras J, Deeg HJ, Ayas M, Bajwa RP, George B, Gupta V, Pasquini R, Schrezenmeier H, Passweg JR, Schultz KR, Eapen MAuthors
Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of WisconsinTao Wang PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Anemia, Aplastic
Bone Marrow Transplantation
Female
Graft vs Host Disease
HLA-DR Serological Subtypes
Histocompatibility Testing
Humans
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Siblings
Survival Rate
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome