Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct 16;124(16):2596-606.
doi: 10.1182/blood-2014-05-576041. Epub 2014 Aug 26.

Nonpermissive HLA-DPB1 mismatch increases mortality after myeloablative unrelated allogeneic hematopoietic cell transplantation

Joseph Pidala  1 , Stephanie J Lee  2 , Kwang Woo Ahn  3 , Stephen Spellman  4 , Hai-Lin Wang  3 , Mahmoud Aljurf  5 , Medhat Askar  6 , Jason Dehn  7 , Marcelo Fernandez Viña  8 , Alois Gratwohl  9 , Vikas Gupta  10 , Rabi Hanna  6 , Mary M Horowitz  3 , Carolyn K Hurley  11 , Yoshihiro Inamoto  2 , Adetola A Kassim  12 , Taiga Nishihori  1 , Carlheinz Mueller  13 , Machteld Oudshoorn  14 , Effie W Petersdorf  2 , Vinod Prasad  15 , James Robinson  16 , Wael Saber  3 , Kirk R Schultz  17 , Bronwen Shaw  18 , Jan Storek  19 , William A Wood  20 , Ann E Woolfrey  2 , Claudio Anasetti  1
Affiliations

Nonpermissive HLA-DPB1 mismatch increases mortality after myeloablative unrelated allogeneic hematopoietic cell transplantation

Joseph Pidala et al. Blood. .

Abstract

We examined current outcomes of unrelated donor allogeneic hematopoietic cell transplantation (HCT) to determine the clinical implications of donor-recipient HLA matching. Adult and pediatric patients who had first undergone myeloablative-unrelated bone marrow or peripheral blood HCT for acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome between 1999 and 2011 were included. All had high-resolution typing for HLA-A, -B, -C, and -DRB1. Of the total (n = 8003), cases were 8/8 (n = 5449), 7/8 (n = 2071), or 6/8 (n = 483) matched. HLA mismatch (6-7/8) conferred significantly increased risk for grades II to IV and III to IV acute graft vs host disease (GVHD), chronic GVHD, transplant-related mortality (TRM), and overall mortality compared with HLA-matched cases (8/8). Type (allele/antigen) and locus (HLA-A, -B, -C, and -DRB1) of mismatch were not associated with overall mortality. Among 8/8 matched cases, HLA-DPB1 and -DQB1 mismatch resulted in increased acute GVHD, and HLA-DPB1 mismatch had decreased relapse. Nonpermissive HLA-DPB1 allele mismatch was associated with higher TRM compared with permissive HLA-DPB1 mismatch or HLA-DPB1 match and increased overall mortality compared with permissive HLA-DPB1 mismatch in 8/8 (and 10/10) matched cases. Full matching at HLA-A, -B, -C, and -DRB1 is required for optimal unrelated donor HCT survival, and avoidance of nonpermissive HLA-DPB1 mismatches in otherwise HLA-matched pairs is indicated.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Adjusted OS curves stratified for 8/8, 7/8, and 6/8 separately. (A) early, (B) intermediate, and (C) advanced disease.
Figure 2
Figure 2
Adjusted OS curves for -DPB1 matched, permissive mismatch, and nonpermissive mismatch cases.
See this image and copyright information in PMC

Comment in

References

    1. Flomenberg N, Baxter-Lowe LA, Confer D, et al. Impact of HLA class I and class II high-resolution matching on outcomes of unrelated donor bone marrow transplantation: HLA-C mismatching is associated with a strong adverse effect on transplantation outcome. Blood. 2004;104(7):1923–1930. - PubMed
    1. Fürst D, Müller C, Vucinic V, et al. High-resolution HLA matching in hematopoietic stem cell transplantation: a retrospective collaborative analysis. Blood. 2013;122(18):3220–3229. - PubMed
    1. Lee SJ, Klein J, Haagenson M, et al. High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation. Blood. 2007;110(13):4576–4583. - PubMed
    1. Morishima Y, Sasazuki T, Inoko H, et al. The clinical significance of human leukocyte antigen (HLA) allele compatibility in patients receiving a marrow transplant from serologically HLA-A, HLA-B, and HLA-DR matched unrelated donors. Blood. 2002;99(11):4200–4206. - PubMed
    1. Petersdorf EW, Longton GM, Anasetti C, et al. Association of HLA-C disparity with graft failure after marrow transplantation from unrelated donors. Blood. 1997;89(5):1818–1823. - PubMed

Publication types

MeSH terms