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Aim To analyze allele mismatches of HLA-A, -B, -C, -DRB1, -DQB1 and haplotype mismatch of donor-recipient pairs on the outcome of haploidentical transplantation combined with a third part cord blood unit. Methods 230 pairs of donor-recipient were performed HLA-A, B, C, DRB1, DQB1 typing using SBT and SSOP methods from January 2012 to December 2014. Results Pairs were divided into HLA-5/10, 6/10, 7/10 and ⩾8/10 groups according to HLA-A, B, C,DRB1 and DQB1 high resolution typing and matched degrees, the 3-year probability of overall survival (OS) for each group were 48.7%, 59.3%, 71.1%, 38.3%( P = 0.068) respectively. HLA>6/10 matched group associated with significant favorable effect on OS compared with HLA-5/10 matched one ( P = 0.041).When the HLA class I antigen matched on the recipient and donor, improved OS and event free survival (EFS) in HLA-6/10 matched group than in HLA-5/10 matched one ( P = 0.017, P = 0.088), especially in single HLA-A loci allele matched one ( P = 0.013, P = 0.013), were observed. As to the third part cord blood unit, sharing the same haplotype with the recipient-donor pairs produced better platelet recovery than the misfit one (95.3% vs 86.2%, P = 0.007), similar result was found in terms of neutrophil recovery (98.8% vs 96.1%, P = 0.022). Conclusions HLA locus mismatch and haplotype mismatch of the donor and recipient should be useful for selection of the most optimum donor. Co-infused of an unrelated cord blood unit sharing the same haplotype with the recipient-donor pairs could improve hematopoietic recovery. [ABSTRACT FROM AUTHOR]

Aim To investigate the impact of patients with anti-HLA antibodies or with donors mismatched at HLA-DP locus on outcomes after unrelated-donor hematopoietic stem cell transplantation (HSCT). Method We explored the data from 123 patients that received allo-HSCT matched for HLA-A, B, C, DRB1, DQB1, and DQA1 (12/12) from unrelated donors from the CMDP with a 2-year follow up. The examination of anti-HLA antibodies was scheduled at 3 time points: before the start of conditioning treatment and 1 month, 3 months after transplantation. Results The presence of anti-HLA antibodies detected before and 1 month, 3 months after transplantation was 37.4% (46/123), 40.2% (47/117), 22.6% (24/106), respectively. 16.4% (18/110) recipients with donors matched in HLA-DPA1 and HLA -DPB1 loci, and the mismatched rate was 83.6% (92/110). Patients with preformed anti-HLA antibodies had delayed platelet recovery. Anti-HLA antibodies detected before and after transplantation were responsible for increased occurrence of grade 2–4 acute graft-versus host disease (aGVHD) and reduced overall survival (OS), especially in acute myeloid leukemia and myelodysplastic syndrome patients. Pre-existing HLA-Ab was an independent risk factor for the GVHD and OS. Unfortunately, we found that HLA-DP mismatches have nothing to do with outcomes after transplantation. For HLA-Ab negative group, HLA-DP matched subgroup had a modest trend towards a lower rate of aGVHD, and a higher occurrence of OS and DFS compared with HLA-DP mismatched subgroup. Conclusions Our results suggest that anti-HLA antibodies detected before and after transplantation had a negative effect of outcomes, but HLA-DP loci mismatches have no significance after HLA- 12/12 matched unrelated donor of allo-HSCT. Anti-HLA antibodies should be the primary consideration in the setting of HLA 12/12-matched unrelated-donor HSCT, followed by the status of HLA-DP matching. [ABSTRACT FROM AUTHOR]

Aim To investigate the impact of donor Killer Immunoglobulin-like Receptors (KIR) genotypes and centromeric motif B (Cen-B) on clinical outcomes after unrelated donor (URD) hematopoietic stem cell transplantation (HSCT) for Chinese population. Method A total of 210 Chinese patients underwent URD-HSCT were investigated in this 4-year retrospective study. KIR genotyping and HLA typing were performed for the population. Results The risk of transplant from Bx1 donors and the benefit of the presence of Cen-B (ignoring the number) were observed for standard risk AML/MDS patients Donor KIR genotype Bx was associated with significant improved OS (P = .026) and RFS (P = .021), and reduced NRM (P = .017) for AML/MDS patients. A much worse survival was observed for transplants from Bx1donors compared to Bx2, Bx3, and Bx4 donors for patients in CR1, ( n = 82; OS: P = .024; RFS: P = .021). Transplant form donors with Cen-B improved OS (HR = .256; 95% CI = .084 to .774; P = .016) and RFS (HR = .252; 95% CI = .084 to .758; P = .014) for AML/MDS patients in CR1. However, the effect did not increase with the number of Cen-B motifs (cB/B vs. cA/B; OS: P = .755; RFS: P = .768). No effect was observed for high risk AML/MDS and ALL/NHL, CML patients. Conclusions Avoiding the selection of HSCT donors with KIR genotype Bx1 is strongly advisable for AML/MDS patients of standard risk. The presence of cen-B motif rather than the number was more important in donor selection for Chinese population. [ABSTRACT FROM AUTHOR]