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The effect of HLA disparity on clinical outcome after HLA‐haploidentical blood and marrow transplantation
Author(s) -
Huo MingRui,
Xu LanPing,
D Li,
Liu DaiHong,
Liu KaiYan,
Chen Huan,
Han Wei,
Chen YuHong,
Y Wang,
Wang JingZhi,
Zhang XiaoHui,
Zhao XiangYu,
Huang XiaoJun
Publication year - 2011
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2011.01499.x
Subject(s) - human leukocyte antigen , medicine , immunology , transplantation , hla a , graft versus host disease , disease , oncology , antigen
Huo M‐R, Xu L‐P, Li D, Liu D‐H, Liu K‐Y, Chen H, Han W, Chen Y‐H, Wang Y, Wang J‐Z, Zhang X‐H, Zhao X‐Y, Huang X‐J. The effect of HLA disparity on clinical outcome after HLA‐haploidentical blood and marrow transplantation.
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01499.x.
© 2011 John Wiley & Sons A/S. Abstract: The relative importance of various human leukocyte antigen (HLA) loci has not been established for unmanipulated HLA‐mismatched/haploidentical transplantation. To address this question, we analyzed the impact of HLA‐A, HLA‐B, HLA‐DRB1, HLA‐DRB3, HLA‐DRB4, and HLA‐DRB5 on the outcome of HLA‐haploidentical transplantation. Four hundred and eighty‐one donor–recipient pairs were fully typed before transplantation. In univariate analysis, HLA‐B mismatch not only demonstrated significant adverse effects on acute graft‐versus‐host disease (GVHD) and transplant‐related mortality but also was associated with reduced overall survival and leukemia‐free survival (LFS). In multivariate analysis, HLA‐B mismatch remained the independent risk factor for acute GVHD and transplant‐related mortality. The high risk of disease and the female donor were found to be significant factors for reduced overall survival and LFS. Furthermore, multiple mismatch of the HLA locus was found to have no synergistic adverse effect on outcomes. Our results suggest that prospective matching of patients and donors for HLA‐B antigen in the unshared HLA haplotype is warranted for HLA‐mismatched/haploidentical transplantation.