TY - JOUR
T1 - Impact of HLA allele mismatch on the clinical outcome in serologically matched related hematopoietic SCT
AU - Fuji, S.
AU - Kanda, J.
AU - Kato, S.
AU - Ikegame, K.
AU - Morishima, S.
AU - Miyamoto, T.
AU - Hidaka, M.
AU - Kubo, K.
AU - Miyamura, K.
AU - Ohashi, K.
AU - Kobayashi, H.
AU - Maesako, Y.
AU - Adachi, S.
AU - Ichinohe, T.
AU - Atsuta, Y.
AU - Kanda, Y.
N1 - Funding Information:
This work was supported in part by a Grant-in-Aid from the Ministry of Health, Labor and Welfare of Japan. We thank all the physicians and data managers at the centers who contributed valuable data on transplantation to the JSHCT. We also thank all the members of the data management committees of the JSHCT for their contributions.
PY - 2014/9/2
Y1 - 2014/9/2
N2 - In unrelated hematopoietic SCT (HSCT), HLA allele mismatch has been shown to have a significant role. To clarify the importance of HLA allele mismatch in the GVH direction in related HSCT, we retrospectively evaluated 2377 patients who received stem cells from an HLA serologically matched related donor in the GVH direction using the database of the Japan Society for Hematopoietic Cell Transplantation. The cumulative incidences of grade II-IV and grade III-IV acute GVHD in patients with an HLA allele-mismatched donor (n=133, 5.6%) were significantly higher than those in patients with an HLA allele-matched donor. Multivariate analyses showed that the presence of HLA allele mismatch was associated with increased risks of grade II-IV and grade III-IV acute GVHD. In particular, HLA-B mismatch and multiple allele mismatches were associated with an increased risk of acute GVHD. The presence of HLA allele mismatch was associated with an inferior OS owing to an increased risk of non-relapse mortality (NRM). In conclusion, the presence of HLA allele mismatch in the GVH direction in related HSCT was associated with increased risks of GVHD and NRM, which led to an inferior OS. HLA allele typing is recommended in related HSCT.
AB - In unrelated hematopoietic SCT (HSCT), HLA allele mismatch has been shown to have a significant role. To clarify the importance of HLA allele mismatch in the GVH direction in related HSCT, we retrospectively evaluated 2377 patients who received stem cells from an HLA serologically matched related donor in the GVH direction using the database of the Japan Society for Hematopoietic Cell Transplantation. The cumulative incidences of grade II-IV and grade III-IV acute GVHD in patients with an HLA allele-mismatched donor (n=133, 5.6%) were significantly higher than those in patients with an HLA allele-matched donor. Multivariate analyses showed that the presence of HLA allele mismatch was associated with increased risks of grade II-IV and grade III-IV acute GVHD. In particular, HLA-B mismatch and multiple allele mismatches were associated with an increased risk of acute GVHD. The presence of HLA allele mismatch was associated with an inferior OS owing to an increased risk of non-relapse mortality (NRM). In conclusion, the presence of HLA allele mismatch in the GVH direction in related HSCT was associated with increased risks of GVHD and NRM, which led to an inferior OS. HLA allele typing is recommended in related HSCT.
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U2 - 10.1038/bmt.2014.141
DO - 10.1038/bmt.2014.141
M3 - Article
C2 - 25000457
AN - SCOPUS:84931832181
SN - 0268-3369
VL - 49
SP - 1187
EP - 1192
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 9
ER -