Details

Autor(en) / Beteiligte

• Fernandez-Viña, Marcelo A.
• Wang, Tao
• Lee, Stephanie J.
• Haagenson, Michael
• Aljurf, Mahmoud
• Askar, Medhat
• Battiwalla, Minoo
• Baxter-Lowe, Lee-Ann
• Gajewski, James
• Jakubowski, Ann A.
• Marino, Susana
• Oudshoorn, Machteld
• Marsh, Steven G.E.
• Petersdorf, Effie W.
• Schultz, Kirk
• Turner, E. Victoria
• Waller, Edmund K.
• Woolfrey, Ann
• Umejiego, John
• Spellman, Stephen R.
• Setterholm, Michelle

Titel

Identification of a permissible HLA mismatch in hematopoietic stem cell transplantation

Ist Teil von

• Blood, 2014-02, Vol.123 (8), p.1270-1278

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• In subjects mismatched in the HLA alleles C*03:03/C*03:04 no allogeneic cytotoxic T-lymphocyte responses are detected in vitro. Hematopoietic stem cell transplantation (HSCT) with unrelated donors (UDs) showed no association between the HLA-C allele mismatches (CAMMs) and adverse outcomes; antigen mismatches at this and mismatches other HLA loci are deleterious. The absence of effect of the CAMM may have resulted from the predominance of the mismatch C*03:03/C*03:04. Patients with hematologic malignancies receiving UD HSCT matched in 8/8 and 7/8 HLA alleles were examined. Transplants mismatched in HLA-C antigens or mismatched in HLA-A, -B, or -DRB1 presented significant differences (P < .0001) in mortality (hazard ratio [HR] = 1.37, 1.30), disease-free survival (HR = 1.33, 1.27), treatment-related mortality (HR = 1.54, 1.54), and grade 3-4 acute graft-versus-host disease (HR = 1.49, 1.77) compared with the 8/8 group; transplants mismatched in other CAMMs had similar outcomes with HR ranging from 1.34 to 172 for these endpoints. The C*03:03/C*03:04 mismatched and the 8/8 matched groups had identical outcomes (HR ranging from 0.96-1.05). The previous finding that CAMMs do not associate with adverse outcomes is explained by the predominance (69%) of the mismatch C*03:03/03:04 in this group that is better tolerated than other HLA mismatches. •Mismatches in alleles C*03:03/C*03:04 were most frequent (68.7%) among the transplants with a single allele level mismatch in HLA-C.•The 7/8 C*03:03/C*03:04 mismatch group was not significantly different from the 8/8 HLA matched transplants in any transplant outcome.