Faculty Collaboration Database

HLA mismatching within or outside of cross-reactive groups (CREGs) is associated with similar outcomes after unrelated hematopoietic stem cell transplantation. Blood 2007 May 01;109(9):4064-70

Date

01/05/2007

Pubmed ID

17202313

Pubmed Central ID

PMC1874562

DOI

10.1182/blood-2006-06-032193

Scopus ID

2-s2.0-34247387564 (requires institutional sign-in at Scopus site)   40 Citations

Abstract

The National Marrow Donor Program maintains a registry of volunteer donors for patients in need of a hematopoietic stem cell transplantation. Strategies for selecting a partially HLA-mismatched donor vary when a full match cannot be identified. Some transplantation centers limit the selection of mismatched donors to those sharing mismatched antigens within HLA-A and HLA-B cross-reactive groups (CREGs). To assess whether an HLA mismatch within a CREG group ("minor") may result in better outcome than a mismatch outside CREG groups ("major"), we analyzed validated outcomes data from 2709 bone marrow and peripheral blood stem cell transplantations. Three-hundred and ninety-six pairs (15%) were HLA-DRB1 allele matched but had an antigen-level mismatch at HLA-A or HLA-B. Univariate and multivariate analyses of engraftment, graft-versus-host disease, and survival showed that outcome is not significantly different between minor and major mismatches (P = .47, from the log-rank test for Kaplan-Meier survival). However, HLA-A, HLA-B, and HLA-DRB1 allele-matched cases had significantly better outcome than mismatched cases (P < .001). For patients without an HLA match, the selection of a CREG-compatible donor as tested does not improve outcome.

Author List

Wade JA, Hurley CK, Takemoto SK, Thompson J, Davies SM, Fuller TC, Rodey G, Confer DL, Noreen H, Haagenson M, Kan F, Klein J, Eapen M, Spellman S, Kollman C

Author

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Alleles
Cross-Sectional Studies
Disease-Free Survival
Female
Graft vs Host Disease
HLA-A Antigens
HLA-B Antigens
HLA-DR Antigens
HLA-DRB1 Chains
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Living Donors
Male
Peripheral Blood Stem Cell Transplantation
Registries
Retrospective Studies
Survival Rate