HLA-C antigen mismatch is associated with worse outcome in unrelated donor peripheral blood stem cell transplantation.
HLA-C antigen mismatch is associated with worse outcome in unrelated donor peripheral blood stem cell transplantation.
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DOI：
10.1016/j.bbmt.2010.09.012
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发表时间：
2011-06
影响因子：
4.3
通讯作者：
Lee, Stephanie J.
中科院分区：
文献类型：
--
作者：
Woolfrey, Ann;Klein, John P.;Haagenson, Michael;Spellman, Stephen;Petersdorf, Effie;Oudshoorn, Machteld;Gajewski, James;Hale, Gregory A.;Horan, John;Battiwalla, Minoo;Marino, Susana R.;Setterholm, Michelle;Ringden, Olle;Hurley, Carolyn;Flomenberg, Neal;Anasetti, Claudio;Fernandez-Vina, Marcelo;Lee, Stephanie J.
关键词：
人类白细胞抗原（HLA）配型与无关供者外周血干细胞（PBSC）移植结果之间的关系尚未确定。1933例在1999-2006年期间因AML、ALL、MDS或CML而移植的无关供者-受者对，其具有HLA-A、B、C、DRB 1、DQA 1和DQB 1的高分辨率HLA分型。结果进行了比较HLA匹配和HLA不匹配对，调整患者和移植的特点。HLA-A、-B、-C和DRB 1等位基因匹配[8/8匹配]与7/8 HLA匹配配对相比，1年生存率更高（56% vs. 47%）。以8/8例HLA匹配的患者为基线（n=1243），HLA-C抗原错配（n=189）与LFS较低有统计学显著相关（RR 1.36 [95% CI 1.13-1.64] p=0.0010），死亡风险增加（RR=1.41 [1.16-1.70]，p=0.0005）、治疗相关死亡率（RR=1.61 [1.25-2.08]，p=0.0002）和III-IV级移植物抗宿主病（RR=1.98 [1.50-2.62]，p<0.0001）。HLA-B抗原或等位基因错配与急性GVHD III-IV级的高风险相关。与8/8个HLA匹配对相比，HLA-C等位基因错配（n=61）、HLA-A抗原/等位基因错配（n=136）、HLA-DRB 1等位基因错配（n=39）或HLA-DQ抗原/等位基因错配（n=114）的结局无统计学显著差异。HLA错配与复发或慢性GVHD无关。HLA-C抗原不匹配的无关PBSC供体与8/8个HLA匹配的供体相比，结局更差。由于样本量小，功效有限，无法评论其他不匹配。
The association between human leukocyte antigen (HLA) matching and outcome in unrelated donor, peripheral blood stem cell (PBSC) transplantation has not been established. 1933 unrelated donor-recipient pairs transplanted between 1999-2006 for AML, ALL, MDS or CML and who had high resolution HLA typing for HLA-A, B, C, DRB1, DQA1 and DQB1 were included in the analysis. Outcomes were compared between HLA-matched and HLA-mismatched pairs, adjusting for patient and transplant characteristics. Matching for HLA-A, -B, -C and DRB1 alleles [8/8 match] was associated with better survival at one year compared with 7/8 HLA-matched pairs (56% vs. 47%). Using 8/8 HLA-matched patients as the baseline (n=1243), HLA-C antigen mismatches (n=189) were statistically significantly associated with lower LFS (RR 1.36 [95% CI 1.13-1.64] p=0.0010), and increased risk for mortality (RR=1.41 [1.16-1.70], p=0.0005), treatment-related mortality (RR=1.61 [1.25-2.08], p=0.0002), and grades III-IV graft-versus-host disease (RR=1.98 [1.50-2.62], p<0.0001). HLA-B antigen or allele mismatching was associated with a higher risk for acute GVHD grades III-IV. No statistically significant differences in outcome were observed for HLA-C allele mismatch (n=61), nor for mismatches at HLA-A antigen/allele (n=136), HLA-DRB1 allele (n=39) or HLA-DQ antigen/allele (n=114) compared to 8/8 HLA-matched pairs. HLA mismatching was not associated with relapse or chronic GVHD. HLA-C antigen mismatched unrelated PBSC donors are associated with worse outcomes compared with 8/8 HLA-matched donors. Limited power due to small sample sized prevents comment about other mismatches.
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影响因子：
11.4
作者：
Shaw, B. E.;Mayor, N. P.;Madrigal, J. A.
通讯作者：
Madrigal, J. A.
影响因子：
20.3
作者：
Ringdén, O;Remberger, M;Fauser, AA
通讯作者：
Fauser, AA
影响因子：
4.3
作者：
Bacigalupo, Andrea;Ballen, Karen;Rizzo, Doug;Giralt, Sergio;Lazarus, Hillard;Ho, Vincent;Apperley, Jane;Slavin, Shimon;Pasquini, Marcelo;Sandmaier, Brenda M.;Barrett, John;Blaise, Didier;Lowski, Robert;Horowitz, Mary
通讯作者：
Horowitz, Mary
影响因子：
20.3
作者：
Crocchiolo, Roberto;Zino, Elisabetta;Benedetti, F.
通讯作者：
Benedetti, F.
DOI：
10.1016/s1470-2045(10)70127-3
发表时间：
2010-07
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Eapen M;Rocha V;Sanz G;Scaradavou A;Zhang MJ;Arcese W;Sirvent A;Champlin RE;Chao N;Gee AP;Isola L;Laughlin MJ;Marks DI;Nabhan S;Ruggeri A;Soiffer R;Horowitz MM;Gluckman E;Wagner JE;Center for International Blood and Marrow Transplant Research;Acute Leukemia Working Party Eurocord (the European Group for Blood Marrow Transplantation);National Cord Blood Program of the New York Blood Center
通讯作者：
National Cord Blood Program of the New York Blood Center