|
|
Blood, 1 November 2004, Vol. 104, No. 9, pp. 2976-2980.
Prepublished online as a Blood First Edition Paper on July 13, 2004; DOI 10.1182/blood-2004-04-1674.
Previous Article | Table of Contents | Next Article 
TRANSPLANTATION
Limits of HLA mismatching in unrelated hematopoietic cell transplantation
Effie W. Petersdorf,
Claudio Anasetti,
Paul J. Martin,
Ted Gooley,
Jerald Radich,
Mari Malkki,
Ann Woolfrey,
Anajane Smith,
Eric Mickelson, and
John A. Hansen
From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
HLA matching between the donor and recipient improves the success of unrelated hematopoietic cell transplantation (HCT). Matched donors are available for only a minority of patients. Further information is needed to evaluate the limits of HLA mismatching. We examined the association of mortality with HLA-A, -B, -C, -DRB1, and -DQB1 mismatching in 948 patients who received a T-replete unrelated HCT for treatment of a marrow disorder. A single HLA allele or antigen mismatch was associated with increased mortality among patients with chronic myeloid leukemia (CML) within 2 years after diagnosis compared to patients with no HLA mismatch, but not among those with more advanced malignancy. In particular, a single HLA-C mismatch conferred increased risk of mortality compared to matches. There was a suggestion for increased mortality with multiple mismatches involving HLA-DQB1 compared to multiple mismatches not involving HLA-DQB1. Donors with a single HLA allele or antigen mismatch may be used for HCT when a fully matched donor is not available for patients with diseases that do not permit time for a lengthy search. Whenever possible, HLA-C mismatches should be avoided for patients with early stage CML, and HLA-DQB1 mismatches should be avoided for patients with multiple mismatches.

CiteULike Connotea Del.icio.us Digg Reddit Technorati What's this?
This article has been cited by other articles:

|
 |

|
 |
 
M. Arora, D. J. Weisdorf, S. R. Spellman, M. D. Haagenson, J. P. Klein, C. K. Hurley, G. B. Selby, J. H. Antin, N. A. Kernan, C. Kollman, et al.
HLA-Identical Sibling Compared With 8/8 Matched and Mismatched Unrelated Donor Bone Marrow Transplant for Chronic Phase Chronic Myeloid Leukemia
J. Clin. Oncol.,
April 1, 2009;
27(10):
1644 - 1652.
[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]
|
 |
|

|
 |

|
 |
 
A. Schrauder, A. Reiter, H. Gadner, D. Niethammer, T. Klingebiel, B. Kremens, C. Peters, W. Ebell, M. Zimmermann, F. Niggli, et al.
Superiority of Allogeneic Hematopoietic Stem-Cell Transplantation Compared With Chemotherapy Alone in High-Risk Childhood T-Cell Acute Lymphoblastic Leukemia: Results From ALL-BFM 90 and 95
J. Clin. Oncol.,
December 20, 2006;
24(36):
5742 - 5749.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
I. Yakoub-Agha, F. Mesnil, M. Kuentz, J. M. Boiron, N. Ifrah, N. Milpied, S. Chehata, H. Esperou, J.-P. Vernant, M. Michallet, et al.
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]
|
 |
|

|
 |

|
 |
 
W. M. Leisenring, P. J. Martin, E. W. Petersdorf, A. E. Regan, N. Aboulhosn, J. M. Stern, S. N. Aker, R. C. Salazar, and G. B. McDonald
An acute graft-versus-host disease activity index to predict survival after hematopoietic cell transplantation with myeloablative conditioning regimens
Blood,
July 15, 2006;
108(2):
749 - 755.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. F. Apperley
Managing the Patient with Chronic Myeloid Leukemia Through and After Allogeneic Stem Cell Transplantation
Hematology,
January 1, 2006;
2006(1):
226 - 232.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|
|