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Blood, 1 October 2004, Vol. 104, No. 7, pp. 1923-1930. Prepublished online as a Blood First Edition Paper on June 10, 2004; DOI 10.1182/blood-2004-03-0803. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-03-0803v1 104/7/1923    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 Flomenberg, N. Articles by Weisdorf, D. Search for Related Content PubMed PubMed Citation Articles by Flomenberg, N. Articles by Weisdorf, D. Related Collections Transplantation Free Research Articles Plenary Papers Clinical Trials and Observations Immunobiology Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  PLENARY PAPERS 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 Neal Flomenberg, Lee Ann Baxter-Lowe, Dennis Confer, Marcelo Fernandez-Vina, Alexandra Filipovich, Mary Horowitz, Carolyn Hurley, Craig Kollman, Claudio Anasetti, Harriet Noreen, Ann Begovich, William Hildebrand, Effie Petersdorf, Barbara Schmeckpeper, Michelle Setterholm, Elizabeth Trachtenberg, Thomas Williams, Edmond Yunis, and Daniel Weisdorf From the Department of Medicine and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA; Department of Surgery, University of California, San Francisco; National Marrow Donor Program, Minneapolis, MN; Department of Oncology, Georgetown University, Washington, DC; Children's Hospital Medical Center, Cincinnati, OH; International Bone Marrow Transplant Registry, Milwaukee, WI; Georgetown University Medical Center, Washington, DC; Jaeb Center for Health Research, Tampa, FL; H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Immunology/Histocompatibility Laboratory, Fairview University Medical Center, Minneapolis, MN; Celera Diagnostics, Alameda, CA; University of Oklahoma Health Sciences Center, Oklahoma City; Fred Hutchinson Cancer Research Center, Seattle, WA; Summercrest Consulting, Columbia, MD; Children's Hospital Oakland Research Institute, Oakland, CA; Department of Pathology, University of New Mexico, Albuquerque; Department of Cancer Immunology and AIDS, Dana Farber Cancer Institute and Department of Pathology, Harvard Medical School, Boston, MA; and University of Minnesota, Minneapolis. Outcome of unrelated donor marrow transplantation is influenced by donor-recipient matching for HLA. Prior studies assessing the effects of mismatches at specific HLA loci have yielded conflicting results. The importance of high-resolution matching for all HLA loci has also not been established. We therefore examined the effects of HLA matching (low or high resolution or both) on engraftment, graft-versus-host disease (GVHD), and mortality in 1874 donor-recipient pairs retrospectively typed at high resolution for HLA-A, -B, -C, -DRB1, -DQ, and -DP. Mismatches at HLA-A, -B, -C, and -DRB1 each had similar adverse effects on mortality. Only HLA-A mismatches demonstrated significant adverse effects on GVHD. These adverse effects on outcome were more evident in transplants with low-resolution versus only high-resolution mismatches. Mismatches for HLA-DQ or -DP did not significantly affect outcome. When high-resolution mismatches at HLA-A, -B, -C, and -DRB1 were considered together, adverse effects on survival and GVHD were observed. We therefore conclude that matching for HLA-C should be incorporated into algorithms for unrelated donor selection. High-resolution mismatches at HLA-A, -B, -C, and -DRB1 adversely affect outcome, but less so than low-resolution mismatches. When clinical circumstances allow, high-resolution class I typing may help optimize donor selection and improve outcome. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: HLA-C alleles can no longer be ignored in bone marrow donor selection Jon J. van Rood Blood 2004 104: 1912-1913. [Full Text] [PDF] This article has been cited by other articles: D. H. Howard, D. Meltzer, C. Kollman, M. Maiers, B. Logan, L. Gragert, M. Setterholm, and M. M. Horowitz Use of Cost-Effectiveness Analysis to Determine Inventory Size for a National Cord Blood Bank Med Decis Making, April 1, 2008; 28(2): 243 - 253. [Abstract] [PDF] B. E. Shaw, T. A. Gooley, M. Malkki, J. A. Madrigal, A. B. Begovich, M. M. Horowitz, A. Gratwohl, O. Ringden, S. G. E. Marsh, and E. W. Petersdorf The importance of HLA-DPB1 in unrelated donor hematopoietic cell transplantation Blood, December 15, 2007; 110(13): 4560 - 4566. [Abstract] [Full Text] [PDF] S. J. Lee, J. Klein, M. Haagenson, L. A. Baxter-Lowe, D. L. Confer, M. Eapen, M. Fernandez-Vina, N. Flomenberg, M. Horowitz, C. K. Hurley, et al. High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation Blood, December 15, 2007; 110(13): 4576 - 4583. [Abstract] [Full Text] [PDF] T. Kawase, Y. Morishima, K. Matsuo, K. Kashiwase, H. Inoko, H. Saji, S. Kato, T. Juji, Y. Kodera, T. Sasazuki, et al. High-risk HLA allele mismatch combinations responsible for severe acute graft-versus-host disease and implication for its molecular mechanism Blood, October 1, 2007; 110(7): 2235 - 2241. [Abstract] [Full Text] [PDF] J. A. Wade, C. Katovich Hurley, S. K. Takemoto, J. Thompson, S. M. Davies, T. C. Fuller, G. Rodey, D. L. Confer, H. Noreen, M. Haagenson, et al. HLA mismatching within or outside of cross-reactive groups (CREGs) is associated with similar outcomes after unrelated hematopoietic stem cell transplantation Blood, May 1, 2007; 109(9): 4064 - 4070. [Abstract] [Full Text] [PDF] C. Cutler, S. Li, V. T. Ho, J. Koreth, E. Alyea, R. J. Soiffer, and J. H. Antin Extended follow-up of methotrexate-free immunosuppression using sirolimus and tacrolimus in related and unrelated donor peripheral blood stem cell transplantation Blood, April 1, 2007; 109(7): 3108 - 3114. [Abstract] [Full Text] [PDF] J. N. Barker Umbilical Cord Blood (UCB) Transplantation: An Alternative to the Use of Unrelated Volunteer Donors? Hematology, January 1, 2007; 2007(1): 55 - 61. [Abstract] [Full Text] [PDF] H. C. Fung, M. A. Higman, and K. van Besien Stem cell transplantation ASH Self-Assessment Program, January 1, 2007; 2007(1): 328 - 360. [Full Text] [PDF] T. C. Wehler, M. Nonn, B. Brandt, C. M. Britten, M. Grone, M. Todorova, I. Link, S. A. Khan, R. G. Meyer, C. 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Allogeneic Marrow Stem-Cell Transplantation From Human Leukocyte Antigen-Identical Siblings Versus Human Leukocyte Antigen-Allelic-Matched Unrelated Donors (10/10) in Patients With Standard-Risk Hematologic Malignancy: A Prospective Study From the French Society of Bone Marrow Transplantation and Cell Therapy J. Clin. Oncol., December 20, 2006; 24(36): 5695 - 5702. [Abstract] [Full Text] [PDF] E. A. Copelan Hematopoietic stem-cell transplantation. N. Engl. J. Med., April 27, 2006; 354(17): 1813 - 1826. [Full Text] [PDF] B. E. Shaw, S. G.E. Marsh, N. P. Mayor, N. H. Russell, and J. A. Madrigal HLA-DPB1 matching status has significant implications for recipients of unrelated donor stem cell transplants Blood, February 1, 2006; 107(3): 1220 - 1226. [Abstract] [Full Text] [PDF] K. van Besien, A. Artz, S. Smith, D. Cao, S. Rich, L. Godley, D. Jones, P. Del Cerro, D. Bennett, B. Casey, et al. 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