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Blood, 1 May 2007, Vol. 109, No. 9, pp. 4064-4070. Prepublished online as a Blood First Edition Paper on January 3, 2007; DOI 10.1182/blood-2006-06-032193. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-06-032193v1 109/9/4064    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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wade, J. A. Articles by Kollman, C. Search for Related Content PubMed PubMed Citation Articles by Wade, J. A. Articles by Kollman, C. Related Collections Transplantation Clinical Trials and Observations Immunobiology Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION HLA mismatching within or outside of cross-reactive groups (CREGs) is associated with similar outcomes after unrelated hematopoietic stem cell transplantation Judith A. Wade1, Carolyn Katovich Hurley2, Steven K. Takemoto3, John Thompson4, Stella M. Davies5, Thomas C. Fuller6, Glenn Rodey7, Dennis L. Confer8, Harriet Noreen9, Michael Haagenson10, Fangyu Kan10, John Klein11, Mary Eapen11, Stephen Spellman8, and Craig Kollman12 1 Department of Surgery, University of Toronto, ON, Canada; 2 Department of Oncology, Georgetown University, Washington, DC; 3 Department of Internal Medicine, St Louis University, MO; 4 Department of Medicine, University of Kentucky, Lexington; 5 Department of Hematology/Oncology, Cincinnati Children's Hospital Medical Center, OH; 6 Department of Pathology, University of Utah, Salt Lake City; 7 Department of Pathology, Baylor College of Medicine, Houston, TX; 8 National Marrow Donor Program, Minneapolis, MN; 9 Immunology Laboratory, University of Minnesota Medical Center, Fairview, Minneapolis; 10 Center for International Blood and Marrow Transplantation Research, Minneapolis, MN; 11 Center for International Blood and Marrow Transplantation Research, Milwaukee, WI; 12 Jaeb Center for Health Research, Tampa, FL The National Marrow Donor Program maintains a registry of volunteer donors for patients in need of a hematopoietic stem cell transplantation. Strategies for selecting a partially HLA-mismatched donor vary when a full match cannot be identified. Some transplantation centers limit the selection of mismatched donors to those sharing mismatched antigens within HLA-A and HLA-B cross-reactive groups (CREGs). To assess whether an HLA mismatch within a CREG group ("minor") may result in better outcome than a mismatch outside CREG groups ("major"), we analyzed validated outcomes data from 2709 bone marrow and peripheral blood stem cell transplantations. Three-hundred and ninety-six pairs (15%) were HLA-DRB1 allele matched but had an antigen-level mismatch at HLA-A or HLA-B. Univariate and multivariate analyses of engraftment, graft-versus-host disease, and survival showed that outcome is not significantly different between minor and major mismatches (P = .47, from the log-rank test for Kaplan-Meier survival). However, HLA-A, HLA-B, and HLA-DRB1 allele–matched cases had significantly better outcome than mismatched cases (P < .001). For patients without an HLA match, the selection of a CREG-compatible donor as tested does not improve outcome. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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