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Blood, Vol. 92 No. 10 (November 15), 1998:
pp. 3515-3520
RAPID COMMUNICATION
Optimizing Outcome After Unrelated Marrow Transplantation by
Comprehensive Matching of HLA Class I and II Alleles in the Donor and
Recipient
Effie W. Petersdorf,
Theodore A. Gooley,
Claudio Anasetti,
Paul J. Martin,
Anajane G. Smith,
Eric M. Mickelson,
Ann E. Woolfrey, and
John A. Hansen
From the Division of Clinical Research, Fred Hutchinson Cancer
Research Center and the University of Washington School of Medicine,
Seattle, WA.
In unrelated marrow transplantation, the benefit of matching class
II HLA-DRB1 and DQB1 alleles of the donor and recipient is well
documented. Little is known about the clinical relevance of matching
for class I HLA-A, B, and C alleles. We used DNA-amplification methods
to identify the HLA-A, B, and C alleles of 300 patients and their
donors. The incidence of graft failure was correlated with multiple
class I mismatching in the donor. The risk of grades III-IV acute
graft-versus-host disease was highest with class II mismatching in the
recipient. Mismatching for a single class I or class II allele had no
effect on survival, but mortality was increased by mismatching for more
than one class I allele and by simultaneous mismatching for class I and
class II alleles. We conclude that matching HLA class I and class II
alleles of the donor and recipient can improve outcome after unrelated
marrow transplantation.
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