1. Impact of HLA mismatch direction on outcomes after umbilical cord blood transplantation for hematological malignant disorders: a retrospective Eurocord-EBMT analysis
- Author
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Cunha, R, Loiseau, P, Ruggeri, A, Sanz, G, Michel, G, Iori, Ap, Paolaiori, A, Socié, G, Arcese, W, Picardi, A, Dias de Heredia, C, Rio, B, Locatelli, F, O'Brien, Ta, Yakoub-Agha, I, Angel Diaz, M, Milpied, N, Bittencourt, H, Pedro Souza, M, Aljurf, M, Charron, D, Boudjedir, K, Labopin, M, Gluckman, E, and Rocha, V
- Subjects
Oncology ,Male ,Cord blood transplantation ,Neutrophils ,Graft vs Host Disease ,Histocompatibility Testing ,HLA Antigens ,Surveys and Questionnaires ,Child ,HLA mismatches direction ,education.field_of_study ,Homozygote ,Hematology ,Middle Aged ,Treatment Outcome ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Cord blood ,Child, Preschool ,Hematologic Neoplasms ,Histocompatibility ,Female ,Cord Blood Stem Cell Transplantation ,Adult ,Blood Platelets ,medicine.medical_specialty ,Adolescent ,Population ,cord blood transplantation ,Human leukocyte antigen ,Disease-Free Survival ,Young Adult ,Internal medicine ,medicine ,Settore MED/05 - Patologia Clinica ,Humans ,education ,Preschool ,malignant diseases ,Aged ,Retrospective Studies ,Malignant diseases ,Transplantation ,Umbilical Cord Blood Transplantation ,business.industry ,Infant ,Multivariate Analysis ,medicine.disease ,Settore MED/15 ,HLA Mismatch ,Graft-versus-host disease ,Immunology ,business ,Settore MED/15 - Malattie del Sangue - Abstract
HLA matching is a critical determinant of outcomes for patients who have undergone umbilical cord blood transplantation (UCBT). Data have been published on the importance of donor/recipient HLA mismatch direction on UCBT outcomes. HLA mismatch in the graft-versus-host (GVH) direction is defined as a donor homozygous at an HLA locus, while the recipient shares one HLA Ag with the donor. HLA mismatch in the host-versus-graft (HVG) direction is defined as a recipient homozygous with the donor sharing one HLA Ag. In our study we focused on confirming, using an independent population, whether transplantation outcomes would be different when HLA mismatch direction was considered. We analyzed 1565 patients who received a single-unit UCBT for malignant disease. Median age was 15 years and 72% of patients were transplanted for leukemia. In multivariate analysis, using the 5/6 HLA-matched population as reference, one or two HLA mismatches in the GVH or HVG direction were not associated with non-relapse related mortality and survival. On the basis of our results, there is no evidence to support a change in the current practice for cord blood unit selection.
- Published
- 2014