TY - JOUR
T1 - Impact of the Direction of HLA Mismatch on Transplantation Outcomes in Single Unrelated Cord Blood Transplantation
AU - Kanda, Junya
AU - Atsuta, Yoshiko
AU - Wake, Atsushi
AU - Ichinohe, Tatsuo
AU - Takanashi, Minoko
AU - Morishima, Yasuo
AU - Taniguchi, Shuichi
AU - Takahashi, Satoshi
AU - Ogawa, Hiroyasu
AU - Ohashi, Kazuteru
AU - Ohno, Yuju
AU - Aotsuka, Nobuyuki
AU - Onishi, Yasushi
AU - Kato, Koji
AU - Nagamura-Inoue, Tokiko
AU - Kanda, Yoshinobu
N1 - Funding Information:
Financial disclosure: This work was supported in part by a Grant-in-Aid for JSPS Fellows (to J.K.).
PY - 2013/2
Y1 - 2013/2
N2 - The impact of the direction of HLA mismatch (MM) on outcome in unrelated cord blood (UCB) transplantation has not yet been clarified. We conducted a retrospective study using national registry data on 2977 patients who underwent transplantation using a single UCB for leukemia or myelodysplastic syndrome. HLA matching was assessed by serologic data for HLA-A, -B, and -DR loci. The median age of the recipients at transplantation was 41 years (range, 0-82 years), and 2300 recipients (77%) were age ≥16 years. The 2-year overall survival rate was 0.46. The presence of MM only in the graft-versus-host direction or only in the host-versus-graft direction was not associated with overall mortality (hazard ratio [HR], 0.88; . P = .317 and HR, 0.95; . P = .670, respectively) compared with 1 bidirectional MM. This finding was consistent in both the child and adult cohorts. The presence of MM only in the graft-versus-host direction was associated with a lower incidence of nonrelapse mortality (HR, 0.65; . P = .040), significant only in the child cohort. No MM category was associated with relapse. Our findings suggest that the direction of HLA MM does not have a significant impact on overall survival after UCB transplantation.
AB - The impact of the direction of HLA mismatch (MM) on outcome in unrelated cord blood (UCB) transplantation has not yet been clarified. We conducted a retrospective study using national registry data on 2977 patients who underwent transplantation using a single UCB for leukemia or myelodysplastic syndrome. HLA matching was assessed by serologic data for HLA-A, -B, and -DR loci. The median age of the recipients at transplantation was 41 years (range, 0-82 years), and 2300 recipients (77%) were age ≥16 years. The 2-year overall survival rate was 0.46. The presence of MM only in the graft-versus-host direction or only in the host-versus-graft direction was not associated with overall mortality (hazard ratio [HR], 0.88; . P = .317 and HR, 0.95; . P = .670, respectively) compared with 1 bidirectional MM. This finding was consistent in both the child and adult cohorts. The presence of MM only in the graft-versus-host direction was associated with a lower incidence of nonrelapse mortality (HR, 0.65; . P = .040), significant only in the child cohort. No MM category was associated with relapse. Our findings suggest that the direction of HLA MM does not have a significant impact on overall survival after UCB transplantation.
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U2 - 10.1016/j.bbmt.2012.09.017
DO - 10.1016/j.bbmt.2012.09.017
M3 - Article
C2 - 23041601
AN - SCOPUS:84872606516
SN - 1083-8791
VL - 19
SP - 247
EP - 254
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 2
ER -