Impact of HLA mismatch direction on outcomes after umbilical cord blood transplantation for hematological malignant disorders: a retrospective Eurocord-EBMT analysis

被引：22

作者：

Cunha, R. ^{[1
]}

Loiseau, P. ^{[2
,3
]}

Ruggeri, A. ^{[1
]}

Sanz, G. ^{[4
]}

Michel, G. ^{[5
]}

Paolalori, A. ^{[6
]}

Socie, G. ^{[7
]}

Arcese, W. ^{[8
]}

Picardi, A. ^{[8
]}

Dias de Heredia, C. ^{[9
]}

Rio, B. ^{[10
]}

Locatelli, F. ^{[11
,12
]}

O'Brien, T. A. ^{[13
]}

Yakoub-Agha, I. ^{[14
]}

Angel Diaz, M. ^{[15
]}

Milpied, N. ^{[16
]}

Bittencourt, H. ^{[17
]}

Pedro Souza, M. ^{[18
]}

Aljurf, M. ^{[19
]}

Charron, D. ^{[2
,3
]}

Boudjedir, K. ^{[1
]}

Labopin, M. ^{[20
]}

Gluckman, E. ^{[1
]}

Rocha, V. ^{[1
,21
]}

机构：

[1] Hop St Louis, Eurocord, F-75010 Paris, France

[2] Hop St Louis, AP HP, Serv Immunol & Histocompatibil, F-75010 Paris, France

[3] Inserm UMRS940, Paris, France

[4] Hosp Univ La Fe, Serv Hematol, Valencia, Spain

[5] Hop Enfants La Timone, Serv Hematol Pediat, Marseille, France

[6] Univ Roma La Sapienza, Dept Biotecnol Cellulari & Ematol, Rome, Italy

[7] Hop St Louis, Bone Marrow Transplant Unit, F-75010 Paris, France

[8] Policlin Univ Tor Vergata, Bone Marrow Transplant Unit, Rome Transplant Network, Rome, Italy

[9] Hosp Valle De Hebron, Serv Hematol Pediat, Barcelona, Spain

[10] Hop Hotel Dieu, Serv Hematol, Paris, France

[11] IRCCS Osped Bambino Gesu, Fdn IRCCS Policlin San Matteo, Dipartimento Oncoematol Pediat, Rome, Italy

[12] Univ Pavia, Rome, Italy

[13] Sydney Childrens Hosp, Cord & Marrow Transplant Program, Sydney, NSW, Australia

[14] Hop Claude Huriez, Serv Hematol, Lille, France

[15] Jesus Childrens Hosp, Madrid, Spain

[16] CHU Bordeaux, Serv Hematol, Pessac, France

[17] Ste Justine Hosp, Pediat Hematol Unit, Montreal, PQ, Canada

[18] Hosp Amaral Carvalho, Bone Marrow Transplant Unit, Jau, Brazil

[19] King Faisal Specialist Hosp & Res Ctr, Bone Marrow Transplant Unit, Ryad, Saudi Arabia

[20] Univ Paris 07, Serv Hematol, European Blood & Marrow Transplant Grp, Acute Leukemia Working Party,Hop St Antoine, Paris, France

[21] Univ Oxford, Churchill Hosp, Hematol Unit, Oxford, England

来源：

BONE MARROW TRANSPLANTATION | 2014年 / 49卷 / 01期

关键词：

cord blood transplantation; malignant diseases; HLA mismatches direction; VERSUS-HOST-DISEASE; BONE-MARROW TRANSPLANTS; HIGH-RISK; GRAFT; ENGRAFTMENT; LEUKEMIA; ANTIBODIES; RECIPIENTS; ANTIGENS; DONORS;

D O I：

10.1038/bmt.2013.120

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

HLA matching is a critical determinant of outcomes for patients who have undergone umbilical cord blood transplantation (UCBT). Data have been published on the importance of donor/recipient HLA mismatch direction on UCBT outcomes. HLA mismatch in the graft-versus-host (GVH) direction is defined as a donor homozygous at an HLA locus, while the recipient shares one HLA Ag with the donor. HLA mismatch in the host-versus-graft (HVG) direction is defined as a recipient homozygous with the donor sharing one HLA Ag. In our study we focused on confirming, using an independent population, whether transplantation outcomes would be different when HLA mismatch direction was considered. We analyzed 1565 patients who received a single-unit UCBT for malignant disease. Median age was 15 years and 72% of patients were transplanted for leukemia. In multivariate analysis, using the 5/6 HLA-matched population as reference, one or two HLA mismatches in the GVH or HVG direction were not associated with non-relapse related mortality and survival. On the basis of our results, there is no evidence to support a change in the current practice for cord blood unit selection.

引用

页码：24 / 29

页数：6

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