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Blood, 20 August 2009, Vol. 114, No. 8, pp. 1689-1695. Prepublished online as a Blood First Edition Paper on June 17, 2009; DOI 10.1182/blood-2008-12-194696. This Article Full Text (PDF) All Versions of this Article: blood-2008-12-194696v1 114/8/1689    most recent e-Letter: Submit a Response Alert me when this article is cited Alert me when e-Letters are posted Alert me if a correction is posted 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 Matsuno, N. Articles by Taniguchi, S. Search for Related Content PubMed PubMed Citation Articles by Matsuno, N. Articles by Taniguchi, S. Social Bookmarking                         What's this?  Previous Article  |  Next Article  Submitted December 15, 2008 Accepted June 5, 2009 Impact of HLA disparity in the graft-versus-host direction on engraftment in adult patients receiving reduced-intensity cord blood transplantation Naofumi Matsuno, Atsushi Wake, Naoyuki Uchida*, Kazuya Ishiwata, Hideki Araoka, Shinsuke Takagi, Masanori Tsuji, Hisashi Yamamoto, Daisuke Kato, Yoshiko Matsuhashi, Sachiko Seo, Kazuhiro Masuoka, Shigesaburo Miyakoshi, Shigeyoshi Makino, Akiko Yoneyama, Yoshinobu Kanda, and Shuichi Taniguchi Department of Hematology, Toranomon Hospital, Tokyo, Japan Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan Division of Hematology, Saitama Medical Center, Jichi Medical School, Saitama, Japan * Corresponding author; email: nuchida{at}toranomon.gr.jp. Delayed engraftment or graft failure is one of the major complications following cord blood transplantation (CBT). In order to investigate factors impacting engraftment, we conducted a retrospective analysis of adult patients who underwent reduced-intensity (RI)-CBT at our institute, in which preparative regimens were mainly consisted of fludarabine, melphalan, and total body irradiation with graft-versus-host (GVH) disease (GVHD) prophylaxis using single calcineurin inhibitors. Among 152 evaluable patients, the cumulative incidence of neutrophil engraftment was 89%. High total nucleated cell and CD34+ cell dose were associated with the faster speed and higher probability of engraftment. In addition, the degree of human leukocyte antigen (HLA) mismatch in the GVH direction was inversely associated with engraftment kinetics, whereas no statistically significant association was observed with the degree of HLA mismatch in the host-versus-graft (HVG) direction. Similarly, the number of HLA class I antigens mismatch in the GVH direction, but not in the HVG direction, showed a negative correlation with engraftment kinetics. HLA disparity did not have significant impact on the development of GVHD or survival. This result indicates the significant role of HLA disparity in the GVH direction in the successful engraftment, raising the novel mechanism responsible for graft failure in CBT. CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this? This article has been cited by other articles: S. Takagi, Y. Ota, N. Uchida, K. Takahashi, K. Ishiwata, M. Tsuji, H. Yamamoto, Y. Asano-Mori, N. Matsuno, K. Masuoka, et al. Successful engraftment after reduced-intensity umbilical cord blood transplantation for myelofibrosis Blood, July 29, 2010; 116(4): 649 - 652. [Abstract] [Full Text] [PDF]

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