Faculty Collaboration Database

The impact of HLA unidirectional mismatches on the outcome of myeloablative hematopoietic stem cell transplantation with unrelated donors. Blood 2013 Jun 06;121(23):4800-6

Date

05/03/2013

Pubmed ID

23637130

Pubmed Central ID

PMC3674677

DOI

10.1182/blood-2013-01-480343

Scopus ID

2-s2.0-84881050569 (requires institutional sign-in at Scopus site)   41 Citations

Abstract

The impact of HLA homozygosity at mismatched (MM) loci on the outcome of 2687 myeloablative unrelated donor hematopoietic cell transplantations performed for malignant disease was evaluated among 4 groups: 7/8 bidirectional MM transplants (donor and recipient heterozygous MM, n = 1393), 7/8 host-versus-graft (HVG) vector MM (recipient homozygous, n = 112), 7/8 graft-versus-host (GVH) vector MM (donor homozygous, n = 119), and 8/8 matches (n = 1063). Multivariate analyses found 7/8 GVH (P = .001) and bidirectional MM groups (P < .0001) had significantly worse transplant-related mortality and overall and disease-free survival than the 8/8 match group, a difference not observed with the 7/8 HVG MM group (P > .01). The 3 7/8 groups differed only for grades III-IV acute GVH disease (GVHD), where HVG MM had less GVHD than the 7/8 bidirectional MM (hazard ratio [HR] 0.52, P = .0016) and GVH MM (HR 0.43, P = .0009) groups but not the 8/8 group (HR 0.83, P = .39). There were no differences between the 7/8 groups for relapse, chronic GVHD, neutrophil engraftment, or graft failure. GVH MM have the same risk as 7/8 bidirectional MM. 7/8 HVG MM confer a reduced risk of acute GVHD without an increased risk of disease relapse or graft failure compared with a 7/8 bidirectional MM.

Author List

Hurley CK, Woolfrey A, Wang T, Haagenson M, Umejiego J, Aljurf M, Askar M, Battiwalla M, Dehn J, Horan J, Oudshoorn M, Pidala J, Saber W, Turner V, Lee SJ, Spellman SR

Authors

Wael Saber MD, MS Professor in the Medicine department at Medical College of Wisconsin
Tao 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

Adolescent
Adult
Aged
Child
Child, Preschool
Female
Follow-Up Studies
Graft vs Host Disease
HLA Antigens
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Histocompatibility
Humans
Infant
Infant, Newborn
Male
Middle Aged
Myeloablative Agonists
Prognosis
Risk Factors
Survival Rate
Transplantation Conditioning
Unrelated Donors
Young Adult