6533b854fe1ef96bd12af559
RESEARCH PRODUCT
High-resolution HLA matching in hematopoietic stem cell transplantation: a retrospective collaborative analysis.
Martin GramatzkiDonald BunjesVladan VucinicGerald WulfMichael PfreundschuhJoannis MytilineosJoannis MytilineosCarlheinz MüllerBertram GlassRainer SchwerdtfegerHermann EinseleKlaus SchwarzKlaus SchwarzDaniel FürstDaniel FürstRenate ArnoldHubert SchrezenmeierHubert SchrezenmeierWolfgang Herrsubject
AdultMaleMultivariate analysisAdolescentmedicine.medical_treatmentImmunologyGraft vs Host DiseaseHematopoietic stem cell transplantationHuman leukocyte antigenHLA-C AntigensBiochemistry03 medical and health sciencesYoung Adult0302 clinical medicineimmune system diseasesTransplantation ImmunologyGermanymedicineHLA-DQ beta-ChainsHumansAlleleSurvival rateSurvival analysis030304 developmental biologyAgedRetrospective Studies0303 health sciencesHLA-A AntigensDonor selectionbusiness.industryHistocompatibility TestingHazard ratioHematopoietic Stem Cell TransplantationCell BiologyHematologyMiddle AgedSurvival AnalysisTissue Donors3. Good healthSurvival RateHLA-B AntigensHematologic NeoplasmsHistocompatibilityImmunologyMultivariate AnalysisFemalebusiness030215 immunologyHLA-DRB1 Chainsdescription
To validate current donor selection strategies based on previous international studies, we retrospectively analyzed 2646 transplantations performed for hematologic malignancies in 28 German transplant centers. Donors and recipients were high resolution typed for HLA-A, -B, -C, -DRB1, and -DQB1. The highest mortality in overall survival analysis was seen for HLA-A, -B, and DRB1 mismatches. HLA-DQB1 mismatched cases showed a trend toward higher mortality, mostly due to HLA-DQB1 antigen disparities. HLA incompatibilities at >1 locus showed additive detrimental effects. HLA mismatching had no significant effect on relapse incidence and primary graft failure. Graft source had no impact on survival end points, neither in univariate nor in multivariate analysis. Higher patient age, advanced disease, transplantations before 2004, patient C2C2 killer cell immunoglobulin-like receptor (KIR)-ligand phenotype, and unavailability of a national donor adversely influenced outcomes in multivariate analysis. Our study confirms the association of HLA-A, -B, -C, and -DRB1 incompatibilities with adverse outcome in hematopoietic stem cell transplantation (HSCT). The relevance of HLA-DQB1 disparities in single mismatched transplantations remains unclear. Similar hazard ratios for allele and antigen mismatches (possibly with an exception for HLA-DQB1) highlight the importance of allele level typing and matching in HSCT. The number of incompatibilities and their type significantly impact survival.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2013-09-19 | Blood |