TY - JOUR
T1 - Prognostic impact of HLA supertype mismatch in single-unit cord blood transplantation
AU - Sugio, Takeshi
AU - Uchida, Naoyuki
AU - Miyawaki, Kohta
AU - Ohno, Yuju
AU - Eto, Tetsuya
AU - Mori, Yasuo
AU - Yoshimoto, Goichi
AU - Kikushige, Yoshikane
AU - Kunisaki, Yuya
AU - Mizuno, Shinichi
AU - Nagafuji, Koji
AU - Iwasaki, Hiromi
AU - Kamimura, Tomohiko
AU - Ogawa, Ryosuke
AU - Miyamoto, Toshihiro
AU - Taniguchi, Shuichi
AU - Akashi, Koichi
AU - Kato, Koji
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Limited 2024.
PY - 2024/4
Y1 - 2024/4
N2 - The “human leukocyte antigen (HLA) supertype” is a functional classification of HLA alleles, which was defined by structural features and peptide specificities, and has been reportedly associated with the clinical outcomes of viral infections and autoimmune diseases. Although the disparity in each HLA locus was reported to have no clinical significance in single-unit cord blood transplantation (sCBT), the clinical significance of the HLA supertype in sCBT remains unknown. Therefore, we retrospectively analyzed clinical data of 1603 patients who received sCBT in eight institutes in Japan between 2000 and 2017. Each HLA allele was categorized into 19 supertypes, and the prognostic effect of disparities was then assessed. An HLA-B supertype mismatch was identified as a poor prognostic factor (PFS: hazard ratio [HR] = 1.23, p = 0.00044) and was associated with a higher cumulative incidence (CI) of relapse (HR = 1.24, p = 0.013). However, an HLA-B supertype mismatch was not associated with the CI of acute and chronic graft-versus-host-disease. The multivariate analysis for relapse and PFS showed the significance of an HLA-B supertype mismatch independent of allelic mismatches, and other previously reported prognostic factors. HLA-B supertype-matched grafts should be selected in sCBT.
AB - The “human leukocyte antigen (HLA) supertype” is a functional classification of HLA alleles, which was defined by structural features and peptide specificities, and has been reportedly associated with the clinical outcomes of viral infections and autoimmune diseases. Although the disparity in each HLA locus was reported to have no clinical significance in single-unit cord blood transplantation (sCBT), the clinical significance of the HLA supertype in sCBT remains unknown. Therefore, we retrospectively analyzed clinical data of 1603 patients who received sCBT in eight institutes in Japan between 2000 and 2017. Each HLA allele was categorized into 19 supertypes, and the prognostic effect of disparities was then assessed. An HLA-B supertype mismatch was identified as a poor prognostic factor (PFS: hazard ratio [HR] = 1.23, p = 0.00044) and was associated with a higher cumulative incidence (CI) of relapse (HR = 1.24, p = 0.013). However, an HLA-B supertype mismatch was not associated with the CI of acute and chronic graft-versus-host-disease. The multivariate analysis for relapse and PFS showed the significance of an HLA-B supertype mismatch independent of allelic mismatches, and other previously reported prognostic factors. HLA-B supertype-matched grafts should be selected in sCBT.
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U2 - 10.1038/s41409-023-02183-1
DO - 10.1038/s41409-023-02183-1
M3 - Article
C2 - 38238452
AN - SCOPUS:85182417080
SN - 0268-3369
VL - 59
SP - 466
EP - 472
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 4
ER -
