Nonpermissive HLA-DPB1 disparity is a significant independent risk factor for mortality after unrelated hematopoietic stem cell transplantation

被引：130

作者：

Crocchiolo, Roberto ^{[2
,3
]}

Zino, Elisabetta ^{[1
]}

Vago, Luca ^{[1
,2
,4
]}

Oneto, Rosi ^{[5
]}

Bruno, Barbara ^{[5
]}

Pollichieni, Simona ^{[6
]}

Sacchi, Nicoletta ^{[6
]}

Sormani, Maria Pia ^{[3
]}

Marcon, Jessica ^{[1
,4
]}

Lamparelli, Teresa ^{[5
]}

Fanin, Renato ^{[7
]}

Garbarino, Lucia ^{[8
]}

Miotti, Valeria ^{[9
]}

Bandini, Giuseppe ^{[10
]}

Bosi, Alberto ^{[11
]}

Ciceri, Fabio ^{[2
]}

Bacigalupo, Andrea ^{[5
]}

Fleischhauer, Katharina ^{[1
,4
]}

Scalari, P. ^{[12
]}

Bontempelli, M. ^{[13
]}

Prinoth, O. ^{[14
]}

Carcassi, C. ^{[15
]}

Marceno, R. ^{[16
]}

Porfirio ^{[17
]}

Rombola, G. ^{[17
]}

Garbarino, L. ^{[18
]}

Lombardo ^{[19
]}

Ferrioli, G. ^{[20
]}

Poli, F. ^{[21
]}

Scalamogna, M. ^{[21
]}

Fleischhauer, K. ^{[22
]}

Mazzi, B. ^{[22
]}

Rossi, F. ^{[23
]}

Mascaretti, L. ^{[23
]}

Albergoni ^{[24
]}

Salvaneschi, L. ^{[25
]}

Martinetti, M. ^{[25
]}

Valentini ^{[26
]}

Nesci, S. ^{[26
]}

Papola, F. ^{[27
]}

Scatena ^{[28
]}

Mariotti ^{[28
]}

Perrone ^{[29
]}

Laurenti ^{[29
]}

Grammatico, P. ^{[30
]}

Mariani, M. ^{[30
]}

Favoino, B. ^{[31
]}

Miotti, V. ^{[32
]}

Guizzardi

Pontiero ^{[33
]}

机构：

[1] Ist Sci San Raffaele, Immunogenet Lab, Unit Immunohematol & Blood Transfus, Div Regenerat Med & Stem Cell Therapy, Via Olgettina 60, I-20132 Milan, Italy

[2] Ist Sci San Raffaele, Hematol & Bone Marrow Transplantat Unit, Dept Oncol, I-20132 Milan, Italy

[3] Univ Genoa, Biostat Unit, Dept Hlth Sci, Genoa, Italy

[4] Ist Sci San Raffaele, San Raffaele Telethon Inst Gene Therapy, Div Regenerat Med & Stem Cell Therapy, I-20132 Milan, Italy

[5] Osped San Martino Genova, Div Hematol, Genoa, Italy

[6] Osped Galliera, Italian Bone Marrow Donor Registry, Genoa, Italy

[7] Univ Udine, Div Hematol & Bone Marrow Transplantat, I-33100 Udine, Italy

[8] Osped San Martino Genova, Immunogenet Lab, Genoa, Italy

[9] Azienda Osped SM Misericordia, Tissue Typing Lab, Udine, Italy

[10] Univ Bologna, Inst Hematol L&A Seragnoli, Bologna, Italy

[11] Univ Florence, Dept Hematol, Florence, Italy

[12] Nuovo Osped Torrette Ancona, Tissue Typing Lab, Ancona, Italy

[13] Osped Riuniti Bergamo, Tissue Typing Lab, I-24100 Bergamo, Italy

[14] Osped Reg, Tissue Typing Lab, Bolzano, Italy

[15] Univ Cagliari, Osped R Binaghi, Tissue Typing Lab, Cagliari, Italy

[16] Osped Cervello, Tissue Typing Lab, Palermo, Italy

[17] Univ Florence, Osped Careggi, Tissue Typing Lab, Florence, Italy

[18] Osped Galliera, Tissue Typing Lab, Genoa, Italy

[19] Univ Milan, Ist Nazl Tumori, Tissue Typing Lab, Milan, Italy

[20] Osped Ca Granda, Tissue Typing Lab, Milan, Italy

[21] Fdn IRCCS Osped Maggiore Policlin, Mangiagalli & Regina Elena, Tissue Typing Lab, Milan, Italy

[22] Ist Sci San Raffaele, Tissue Typing Lab, I-20132 Milan, Italy

[23] Osped San Gerardo, Tissue Typing Lab, Monza, Italy

[24] Osped Padua, Tissue Typing Lab, Padua, Italy

[25] Univ Pavia, Fdn IRCCS Policlin S Matteo, Tissue Typing Lab, Via Palestro 3, I-27100 Pavia, Italy

[26] Osped S Salvatore, Tissue Typing Lab, Pesaro, Italy

[27] Osped S Salvatore, Tissue Typing Lab, Laquila, Italy

[28] Osped Cisanello, Tissue Typing Lab, Pisa, Italy

[29] Policlin Umberto 1, Tissue Typing Lab, Rome, Italy

[30] Osped S Camillo Roma, Tissue Typing Lab, Rome, Italy

[31] Policlin Consorziale, Tissue Typing Lab, Bari, Italy

[32] Osped S M della Misericordia, Tissue Typing Lab, Udine, Italy

[33] Policlin GB Rossi, Tissue Typing Lab, Verona, Italy

[34] Nuovo Osped Torrette Ancona, Div Hematol, Ancona, Italy

[35] Osped Riuniti Bergamo, Div Hematol, I-24100 Bergamo, Italy

[36] Osped Reg, Dept Hematol, Bolzano, Italy

[37] Osped Oncol A Businco, Div Hematol, Cagliari, Italy

[38] Osped Oncol A Businco, Bone Marrow Transplantat Ctr, Cagliari, Italy

[39] Univ Cagliari, Osped R Binagli, Bone Marrow Transplantat Unit, Cagliari, Italy

[40] Osped Ferrarotto, Div Hematol & Bone Marrow Transplantat, Catania, Italy

[41] Univ Florence, Osped Careggi, Dept Hematol, Florence, Italy

[42] Osped San Martino Genova, Div Hematol, Genoa, Italy

[43] IRCCS G Gaslini, Div Hematol & Oncol, Genoa, Italy

[44] Univ Milan, Ist Nazl Tumori, Hematol, Bone Marrow Transplantat Unit, Milan, Italy

[45] Osped C Granda Niguarda, Div Hematol, Milan, Italy

[46] Fdn IRCCS Osped Maggiore Policlin, Mangiagalli & Regina Elena, Dept Hematol, Milan, Italy

[47] Ist Sci San Raffaele, Hematol & Bone Marrow Transplantat Unit, Milan, Italy

[48] IRCCS Clin Humanitas, Transplantat Unit, Dept Oncol Hematol, Rozzano, Italy

[49] Univ Milano Bicocca, Osped S Gerardo, Div Hematol, Monza, Italy

[50] Univ Milano Bicocca, Osped S Gerardo, Transplant Unit, Monza, Italy

来源：

BLOOD | 2009年 / 114卷 / 07期

关键词：

VERSUS-HOST-DISEASE; DONOR MARROW TRANSPLANTATION; HLA CLASS-I; T-LYMPHOCYTES; LINKAGE DISEQUILIBRIUM; CRUCIAL ROLE; DP; GRAFT; MISMATCHES; EPITOPE;

D O I：

10.1182/blood-2009-01-200378

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The importance of donor-recipient human leukocyte antigen (HLA)-DPB1 matching for the clinical outcome of unrelated hematopoietic stem cell transplantation (HSCT) is controversial. We have previously described an algorithm for nonpermissive HLA-DPB1 disparities involving HLA-DPB1*0901,*1001,*1701,*0301,*1401,*4501, based on T-cell alloreactivity patterns. By revisiting the immunogenicity of HLA-DPB1*02, a modified algorithm was developed and retrospectively tested in 621 unrelated HSCTs facilitated through the Italian Registry for onco-hematologic adult patients. The modified algorithm proved to be markedly more predictive of outcome than the original one, with significantly higher KaplanMeier probabilities of 2-year survival in permissive compared with nonpermissive transplantations (55% vs 39%, P = .005). This was the result of increased adjusted hazards of nonrelapse mortality (hazard ratio [HR] = 1.74; confidence interval [CI], 1.19-2.53; P = .004) but not of relapse (HR = 1.02; CI, 0.73-1.42; P = .92). The increase in the hazards of overall mortality by nonpermissive HLA-DPB1 disparity was similar in 10 of 10 (HR = 2.12; CI, 1.23-3.64; P = .006) and 9 of 10 allele-matched transplantations (HR = 2.21; CI, 1.28-3.80; P = .004), both in early-stage and in advanced-stage disease. These data call for revisiting current HLA matching strategies for unrelated HSCT, suggesting that searches should be directed up-front toward identification of HLA-DPB1 permissive, 10 of 10 or 9 of 10 matched donors. (Blood. 2009; 114:1437-1444)

引用

页码：1437 / 1444

页数：8

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