Nonpermissive HLA-DPB1 disparity is a significant independent risk factor for mortality after unrelated hematopoietic stem cell transplantation

Author:

Crocchiolo Roberto12,Zino Elisabetta3,Vago Luca134,Oneto Rosi5,Bruno Barbara5,Pollichieni Simona6,Sacchi Nicoletta6,Sormani Maria Pia2,Marcon Jessica34,Lamparelli Teresa5,Fanin Renato7,Garbarino Lucia8,Miotti Valeria9,Bandini Giuseppe10,Bosi Alberto11,Ciceri Fabio1,Bacigalupo Andrea5,Fleischhauer Katharina34,

Affiliation:

1. Hematology and Bone Marrow Transplantation Unit, Department of Oncology, San Raffaele Scientific Institute, Milano, Italy;

2. Biostatistics Unit, Department of Health Sciences, University of Genova, Genova;

3. Immunogenetics Laboratory, Unit of Immunohematology and Blood Transfusion, Division of Regenerative Medicine and Stem Cell Therapy, San Raffaele Scientific Institute, Milano;

4. San Raffaele Telethon Institute for Gene Therapy, Division of Regenerative Medicine and Stem Cell Therapy, San Raffaele Scientific Institute, Milano;

5. Division of Hematology, Ospedale San Martino, Genova;

6. Italian Bone Marrow Donor Registry, Ospedale Galliera, Genova;

7. Division of Hematology and Bone Marrow Transplantation, University of Udine, Udine;

8. Immunogenetics Laboratory, Ospedale San Martino, Genova;

9. Tissue Typing Laboratory, Azienda Ospedaliera S. M. Misericordia, Udine;

10. Institute of Hematology L. & A. Seragnoli, University of Bologna, Bologna; and

11. Department of Hematology, University of Florence, Florence, Italy

Abstract

AbstractThe importance of donor-recipient human leukocyte antigen (HLA)-DPB1 matching for the clinical outcome of unrelated hematopoietic stem cell transplantation (HSCT) is controversial. We have previously described an algorithm for nonpermissive HLA-DPB1 disparities involving HLA-DPB1*0901,*1001,*1701,*0301,*1401,*4501, based on T-cell alloreactivity patterns. By revisiting the immunogenicity of HLA-DPB1*02, a modified algorithm was developed and retrospectively tested in 621 unrelated HSCTs facilitated through the Italian Registry for oncohematologic adult patients. The modified algorithm proved to be markedly more predictive of outcome than the original one, with significantly higher Kaplan-Meier probabilities of 2-year survival in permissive compared with nonpermissive transplantations (55% vs 39%, P = .005). This was the result of increased adjusted hazards of nonrelapse mortality (hazard ratio [HR] = 1.74; confidence interval [CI], 1.19-2.53; P = .004) but not of relapse (HR = 1.02; CI, 0.73-1.42; P = .92). The increase in the hazards of overall mortality by nonpermissive HLA-DPB1 disparity was similar in 10 of 10 (HR = 2.12; CI, 1.23-3.64; P = .006) and 9 of 10 allele-matched transplantations (HR = 2.21; CI, 1.28-3.80; P = .004), both in early-stage and in advanced-stage disease. These data call for revisiting current HLA matching strategies for unrelated HSCT, suggesting that searches should be directed up-front toward identification of HLA-DPB1 permissive, 10 of 10 or 9 of 10 matched donors.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3