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Prepublished online as a Blood First Edition Paper on April 24, 2003; DOI 10.1182/blood-2003-02-0430. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-02-0430v1 102/4/1541    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kanda, Y. Articles by Imamura, M. Search for Related Content PubMed PubMed Citation Articles by Kanda, Y. Articles by Imamura, M. Related Collections Immunobiology Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 August 2003, Vol. 102, No. 4, pp. 1541-1547 TRANSPLANTATION Allogeneic hematopoietic stem cell transplantation from family members other than HLA-identical siblings over the last decade (1991-2000) Yoshinobu Kanda, Shigeru Chiba, Hisamaru Hirai, Hisashi Sakamaki, Tohru Iseki, Yoshihisa Kodera, Takahiro Karasuno, Shinichiro Okamoto, Noriyuki Hirabayashi, Koji Iwato, Atsuo Maruta, Yoshihiro Fujimori, Tatsuo Furukawa, Shin Mineishi, Keitaro Matsuo, Nobuyuki Hamajima, and Masahiro Imamura From the Department of Cell Therapy and Transplantation Medicine, University of Tokyo Hospital, Tokyo, Japan; Hematology Division, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan; Advanced Clinical Research Center, Research Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan; Japanese Red Cross Nagoya First Hospital, Aichi, Japan; 5th Department of Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; Keio University School of Medicine, Tokyo, Japan; Department of Hematology, Nagoya Daini Red Cross Hospital, Aichi, Japan; Department of Internal Medicine, Hiroshima Atomic Bomb Survivors Hospital, Hiroshima, Japan; Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan; Department of Medicine, Hyogo College of Medicine, Hyogo, Japan; Division of Bone Marrow Transplantation, Niigata University Medical Hospital, Niigata, Japan; Stem Cell Transplant Unit, National Cancer Center Hospital, Tokyo, Japan; Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Aichi, Japan; and Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. The reported outcome of hematopoietic stem cell transplantation (HSCT) from HLA-mismatched family members has been inconsistent. The object of this study was to evaluate the true impact of HLA-mismatch by using recent data from a homogenous population, excluding HSCT procedures that used graft manipulations, and by considering genotypic matching. Clinical data of 2947 patients who underwent allogeneic HSCT for leukemia or myelodysplastic syndrome were extracted from the database of the Japan Society for Hematopoietic Cell Transplantation. The main outcome measures were survival and the incidence of graft-versus-host disease (GVHD). The presence of serologic HLA-mismatch, higher age, and high-risk disease were identified as independent risk factors for both shorter survival and the development of grade III to IV acute GVHD. The impact of HLA-mismatch on survival was more relevant in standard-risk patients. These findings persisted when we used genotypic HLA matching. Survival after one-locus–mismatched HSCT was equivalent to that after HLA-matched unrelated HSCT. We concluded that when a one-locus–mismatched family donor is available for high-risk patients, immediate HSCT using this donor is warranted. In standard-risk patients, however, survival after one-locus–mismatched HSCT is significantly shorter than that after HLA-matched HSCT, and the indications for HSCT should be considered carefully. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. Takahashi, J. Ooi, A. Tomonari, T. Konuma, N. Tsukada, M. Oiwa-Monna, K. Fukuno, M. Uchiyama, K. Takasugi, T. Iseki, et al. Comparative single-institute analysis of cord blood transplantation from unrelated donors with bone marrow or peripheral blood stem-cell transplants from related donors in adult patients with hematologic malignancies after myeloablative conditioning regimen Blood, February 1, 2007; 109(3): 1322 - 1330. [Abstract] [Full Text] [PDF] K. Matsuda, K. Yamauchi, M. Tozuka, T. Suzuki, M. Sugano, E. Hidaka, K. Sano, and T. Katsuyama Monitoring of Hematopoietic Chimerism by Short Tandem Repeats, and the Effect of CD Selection on Its Sensitivity Clin. Chem., December 1, 2004; 50(12): 2411 - 2414. [Full Text] [PDF] T. Ichinohe, T. Uchiyama, C. Shimazaki, K. Matsuo, S. Tamaki, M. Hino, A. Watanabe, M. Hamaguchi, S. Adachi, H. Gondo, et al. Feasibility of HLA-haploidentical hematopoietic stem cell transplantation between noninherited maternal antigen (NIMA)-mismatched family members linked with long-term fetomaternal microchimerism Blood, December 1, 2004; 104(12): 3821 - 3828. [Abstract] [Full Text] [PDF] M. A. de Witte and T. N. M. Schumacher Generating CTL by HLA transplant Blood, June 15, 2004; 103(12): 4381 - 4382. [Full Text] [PDF]

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