Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy

被引：196

作者：

Eapen, Mary ^{[1
,2
]}

Klein, John P. ^{[1
,3
]}

Ruggeri, Annalisa ^{[4
]}

Spellman, Stephen ^{[5
]}

Lee, Stephanie J. ^{[6
]}

Anasetti, Claudio ^{[7
]}

Arcese, William ^{[8
]}

Barker, Juliet N. ^{[9
]}

Baxter-Lowe, Lee Ann ^{[10
]}

Brown, Maria ^{[5
]}

Fernandez-Vina, Marcelo A. ^{[11
]}

Freeman, John ^{[12
]}

He, Wensheng ^{[1
,2
]}

Iori, Anna Paola ^{[13
]}

Horowitz, Mary M. ^{[1
,2
]}

Locatelli, Franco ^{[14
,15
]}

Marino, Susana ^{[16
]}

Maiers, Martin ^{[12
]}

Michel, Gerard ^{[17
]}

Sanz, Guillermo F. ^{[18
]}

Gluckman, Eliane ^{[4
]}

Rocha, Vanderson ^{[19
]}

机构：

[1] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA

[2] Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA

[3] Med Coll Wisconsin, Div Biostat, Milwaukee, WI 53226 USA

[4] Hop St Louis, Eurocord, Paris, France

[5] Ctr Int Blood & Marrow Transplant Res, Natl Marrow Donor Program, Minneapolis, MN USA

[6] Univ Washington, Fred Hutchinson Canc Res Ctr, Seattle, WA 98195 USA

[7] Univ S Florida, H Lee Moffitt Canc Ctr, Tampa, FL 33682 USA

[8] Univ Roma Tor Vergata, Rome Transplant Network, Rome, Italy

[9] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA

[10] Univ Calif San Francisco, San Francisco, CA 94143 USA

[11] Stanford Univ, Palo Alto, CA 94304 USA

[12] Natl Marrow Donor Program, Minneapolis, MN USA

[13] Univ Rome, Rome, Italy

[14] Osped Pediat Bambino Gesu, Inst Ricovero & Cura Carattere Sci, Rome, Italy

[15] Univ Pavia, I-27100 Pavia, Italy

[16] Univ Chicago, Chicago, IL 60637 USA

[17] Univ Hosp Marseille, Marseille, France

[18] Hosp Univ La Fe, Valencia, Spain

[19] Churchill Hosp, Oxford OX3 7LJ, England

来源：

BLOOD | 2014年 / 123卷 / 01期

关键词：

HEMATOPOIETIC-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; ACUTE-LEUKEMIA; RETROSPECTIVE ANALYSIS; UNRELATED DONORS; COMPETING RISKS; GRAFT; RECIPIENTS; ADULTS; ANTIBODIES;

D O I：

10.1182/blood-2013-05-506253

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We studied the effect of allele-level matching at human leukocyte antigen (HLA)-A, -B, -C, and -DRB1 in 1568 single umbilical cord blood (UCB) transplantations for hematologic malignancy. The primary end point was nonrelapse mortality (NRM). Only 7% of units were allele matched at HLA-A, -B, -C, and -DRB1; 15% were mismatched at 1, 26% at 2, 30% at 3, 16% at 4, and 5% at 5 alleles. In a subset, allele-level HLA match was assigned using imputation; concordance between HLA-match assignment and outcome correlation was confirmed between the actual and imputed HLA-match groups. Compared with HLA-matched units, neutrophil recovery was lower with mismatches at 3, 4, or 5, but not 1 or 2 alleles. NRM was higher with units mismatched at 1, 2, 3, 4, or 5 alleles compared with HLA-matched units. The observed effects are independent of cell dose and patient age. These data support allele-level HLA matching in the selection of single UCB units.

引用

页码：133 / 140

页数：8

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