2017年2月
Impact of Human Leukocyte Antigen Allele Mismatch in Unrelated Bone Marrow Transplantation with Reduced-Intensity Conditioning Regimen.
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
- 巻
- 23
- 号
- 2
- 開始ページ
- 300
- 終了ページ
- 309
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1016/j.bbmt.2016.11.009
- 出版者・発行元
- ELSEVIER SCIENCE INC
The impact of HLA mismatch in hematopoietic stem cell transplantation with reduced-intensity conditioning (RIC) has not been fully examined. We analyzed a total of 1130 cases to examine the effects of HLA allele mismatch in unrelated bone marrow transplantation (BMT) with RIC in the Japan Marrow Donor Program registry cohort. Compared with HLA 8/8-allele match (n =720, 8/8 match), both 1 (n = 295, 7/8 match) and 2 allele mismatches (n=115, 6/8 match) were associated with significant reduction of overall survival (OS) (hazard ratio IHRI, 1.34; P=.0024 and HR, 1.33; P=.035 for 7/8 and 6/8 match, respectively). The incidence of grades 2 to 4 acute graft-versus-host disease (aGVHD) increased with increasing number of mismatched alleles (HR, 1.36 and HR, 2.08 for 7/8 and 6/8 match, respectively). Nonrelapse mortality showed a similar tendency to aGVHD (HR, 1.35 for 7/8 and HR, 1.63 for 6/8). One-allele mismatches at the HLA-A or -B and HLA-C loci were significantly associated with inferior OS compared with 8/8 match (HR, 1.64 for A or B mismatch and HR, 1.41 for C mismatch), whereas HLA-DRB1 allele mismatch was not (HR, 1.16; P=.30). However, the effect of HLA-A or -B and -C mismatch on OS was not observed in those who received RIC BMT since 2010, in contrast to recipients before 2010. These results suggested that in unrelated RIC BMT, 1-allele mismatch is associated with poorer outcome, and the impact of HLA mismatch may differ depending on the HLA locus, although these HLA mismatch effects may be different in recent cases. (C) 2017 American Society for Blood and Marrow Transplantation.
- リンク情報
-
- DOI
- https://doi.org/10.1016/j.bbmt.2016.11.009
- J-GLOBAL
- https://jglobal.jst.go.jp/detail?JGLOBAL_ID=201702201094433681
- PubMed
- https://www.ncbi.nlm.nih.gov/pubmed/27845190
- Web of Science
- https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000392894300015&DestApp=WOS_CPL
- URL
- http://europepmc.org/abstract/med/27845190
- ID情報
-
- DOI : 10.1016/j.bbmt.2016.11.009
- ISSN : 1083-8791
- eISSN : 1523-6536
- J-Global ID : 201702201094433681
- ORCIDのPut Code : 32956376
- PubMed ID : 27845190
- Web of Science ID : WOS:000392894300015