Evaluation of HLA matching in unrelated hematopoietic stem cell transplantation for nonmalignant disorders. Blood 2012 Oct 04;120(14):2918-24
Date
07/26/2012Pubmed ID
22829628Pubmed Central ID
PMC3466972DOI
10.1182/blood-2012-03-417758Scopus ID
2-s2.0-84867297995 (requires institutional sign-in at Scopus site) 94 CitationsAbstract
The importance of human leukocyte antigen (HLA) matching in unrelated donor transplantation for nonmalignant diseases (NMD) has yet to be defined. We analyzed data from 663 unrelated marrow and peripheral blood stem cell transplants performed from 1995 to 2007 for treatment of NMD. Transplantation from a donor mismatched at the HLA-A, -B, -C, or -DRB1, but not -DQB1 or -DPB1, loci was associated with higher mortality in multivariate analyses (P = .002). The hazard ratio for mortality for single (7/8) and double mismatched (6/8) transplants was 1.29 (0.97-1.72; P = .079) and 1.82 (1.30-2.55; P = .0004), respectively, compared with 8/8 matched transplants. HLA mismatches were not associated with acute or chronic GVHD, but were strongly associated with graft failure. After adjustment for other factors, the odds ratio for graft failure for 7/8 and 6/8 (allele and/or antigen) matched pairs compared with 8/8 matched transplants was 2.81 (1.74-4.54; P < .0001) and 2.22 (1.26-3.97; P = .006), respectively. Patients with NMD should receive transplants from allele matched (8/8) donors if possible. Unlike the case with malignancies, HLA mismatching in NMD is associated with graft failure rather than GVHD.
Author List
Horan J, Wang T, Haagenson M, Spellman SR, Dehn J, Eapen M, Frangoul H, Gupta V, Hale GA, Hurley CK, Marino S, Oudshoorn M, Reddy V, Shaw P, Lee SJ, Woolfrey AAuthors
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
Blood Donors
Bone Marrow Transplantation
Child
Child, Preschool
Female
Graft Rejection
Graft vs Host Disease
HLA Antigens
Hematologic Diseases
Histocompatibility
Humans
Infant
Infant, Newborn
Middle Aged
Peripheral Blood Stem Cell Transplantation
Survival Rate
Unrelated Donors
Young Adult