High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation

被引：963

作者：

Lee, Stephanie J. ^{[1
]}

Klein, John ^{[2
]}

Haagenson, Michael ^{[3
]}

Baxter-Lowe, Lee Ann ^{[4
]}

Confer, Dennis L. ^{[5
]}

Eapen, Mary ^{[2
]}

Fernandez-Vina, Marcelo ^{[6
]}

Flomenberg, Neal ^{[7
]}

Horowitz, Mary ^{[2
]}

Hurley, Carolyn K. ^{[8
]}

Noreen, Harriet ^{[9
]}

Oudshoorn, Machteld ^{[10
]}

Petersdorf, Effie ^{[1
]}

Setterholm, Michelle ^{[5
]}

Spellman, Stephen ^{[5
]}

Weisdorf, Daniel ^{[11
]}

Williams, Thomas M. ^{[12
]}

Anasetti, Claudio ^{[13
]}

机构：

[1] Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA

[2] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA

[3] Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN USA

[4] Univ Calif San Francisco, Dept Surg, San Francisco, CA 94143 USA

[5] Natl Marrow Donor Program, Minneapolis, MN USA

[6] MD Anderson Canc Ctr, Houston, TX USA

[7] Thomas Jefferson Univ Hosp, Philadelphia, PA 19107 USA

[8] Georgetown Univ, Med Ctr, Dept Oncol, Washington, DC 20007 USA

[9] Univ Minnesota, Med Ctr, Immunol Histocompatibility Lab, Fairview, MN USA

[10] Europdonor Fdn, Leiden, Netherlands

[11] Univ Minnesota, Blood & Marrow Transplantat Program, Minneapolis, MN USA

[12] Univ New Mexico, Dept Pathol, Albuquerque, NM 87131 USA

[13] H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL USA

来源：

BLOOD | 2007年 / 110卷 / 13期

关键词：

D O I：

10.1182/blood-2007-06-097386

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The relative importance of various human leukocyte antigen (HLA) loci and the resolution level at which they are matched has not been fully defined for unrelated donor transplantation. To address this question, National Marrow Donor Program data from 3857 transplantations performed from 1988 to 2003 in the United States were analyzed. Patient-donor pairs were fully typed for HLA-A, -B, -C, -DRB1, -DQB1, -DQA1, -DPB1, and -DPA1 alleles. High-resolution DNA matching for HLA-A, -B, -C, and -DRB1 (8/8 match) was the minimum level of matching associated with the highest survival. A single mismatch detected by low- or high-resolution DNA testing at HLA-A, -B, -C or -DRB1 (7/8 match) was associated with higher mortality (relative risk, 1.25; 95% Cl, 1.13-1.38; P < .001) and 1-year survival of 43% compared with 52% for 8/8 matched pairs. Single mismatches at HLA-B or HLA-C appear better tolerated than mismatches at HLA-A or HLA-DRB1. Mismatching at 2 or more loci compounded the risk. Mismatching at HLA-DP or -DQ loci and donor factors other than HLA type were not associated with survival. In multivariate modeling, patient age, race, disease stage, and cytomegalovirus status were as predictive of survival as donor HLA matching. High-resolution DNA matching for HLA-A, -B, -C, and -DRB1 alleles is associated with higher rates of survival.

引用

页码：4576 / 4583

页数：8

共 22 条

[1] Impact of HLA class I and class II high-resolution matching on outcomes of unrelated donor bone marrow transplantation: HLA-C mismatching is associated with a strong adverse effect on transplantation outcome [J].

Flomenberg, N ;

Baxter-Lowe, LA ;

Confer, D ;

Fernandez-Vina, M ;

Filipovich, A ;

Horowitz, M ;

Hurley, C ;

Kollman, C ;

Anasetti, C ;

Noreen, H ;

Begovich, A ;

Hildebrand, W ;

Petersdorf, E ;

Schmeckpeper, B ;

Setterholm, M ;

Trachtenberg, E ;

Williams, T ;

Yunis, E ;

Weisdorf, D .

BLOOD, 2004, 104 (07) :1923-1930

[2] CLINICAL MANIFESTATIONS OF GRAFT VERSUS HOST DISEASE IN HUMAN RECIPIENTS OF MARROW FROM HL-A-MATCHED SIBLING DONORS [J].

GLUCKSBERG, H ;

STORB, R ;

FEFER, A ;

BUCKNER, CD ;

NEIMAN, PE ;

CLIFT, RA ;

LERNER, KG ;

THOMAS, ED .

TRANSPLANTATION, 1974, 18 (04) :295-304

[3]

Gooley TA, 1999, STAT MED, V18, P695, DOI 10.1002/(SICI)1097-0258(19990330)18:6<695::AID-SIM60>3.3.CO

[4]

2-F

[5] Impact of HLA class I high-resolution mismatches on chronic graft-versus-host disease and survival of patients given hematopoietic stem cell grafts from unrelated donors [J].

Greinix, HT ;

Faé, I ;

Schneider, B ;

Rosenmayr, A ;

Mitterschiffthaler, A ;

Pelzmann, B ;

Kalhs, P ;

Lechner, K ;

Mayr, WR ;

Fischer, GF .

BONE MARROW TRANSPLANTATION, 2005, 35 (01) :57-62

[6] HLA-C mismatch is associated with inferior survival after unrelated donor non-myeloablative hematopoietic stem cell transplantation [J].

Ho, VT ;

Kim, HT ;

Liney, D ;

Milford, E ;

Gribben, J ;

Cutler, C ;

Lee, SJ ;

Antin, JH ;

Soiffer, RJ ;

Alyea, EP .

BONE MARROW TRANSPLANTATION, 2006, 37 (09) :845-850

[7] A high degree of HLA disparity arises from limited allelic diversity: Analysis of 1775 unrelated bone marrow transplant donor-recipient pairs [J].

Hurley, Carolyn Katovich ;

Fernandez-Vina, Marcelo ;

Hildebrand, William H. ;

Noreen, Harriet J. ;

Trachtenberg, Elizabeth ;

Williams, Thomas M. ;

Baxter-Lowe, Lee Ann ;

Begovich, Ann B. ;

Petersdorf, Effie ;

Selvakumar, Annamalai ;

Stastny, Peter ;

Hegland, Janet ;

Hartzman, Robert J. ;

Carston, Michael ;

Gandham, Sharavi ;

Kollman, Craig ;

Nelson, Gene ;

Spellman, Stephen ;

Setterholm, Michelle .

HUMAN IMMUNOLOGY, 2007, 68 (01) :30-40

[8] High-risk HLA allele mismatch combinations responsible for severe acute graft-versus-host disease and implication for its molecular mechanism [J].

Kawase, Takakazu ;

Morishima, Yasuo ;

Matsuo, Keitaro ;

Kashiwase, Koichi ;

Inoko, Hidetoshi ;

Saji, Hiroh ;

Kato, Shunichi ;

Juji, Takeo ;

Kodera, Yoshihisa ;

Sasazuki, Takehiko .

BLOOD, 2007, 110 (07) :2235-2241

[9]

Klein J., 2003, SURVIVAL ANAL STAT M

[10] Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age [J].

Kollman, C ;

Howe, CWS ;

Anasetti, C ;

Antin, JH ;

Davies, SM ;

Filipovich, AH ;

Hegland, J ;

Kamani, N ;

Kernan, NA ;

King, R ;

Ratanatharathorn, V ;

Weisdorf, D ;

Confer, DL .

BLOOD, 2001, 98 (07) :2043-2051

← 1 2 3 →