94-P: THE IMPACT OF HLA HIGH RESOLUTION TYPING MISMATCHING OF DONOR-RECIPIENT PAIRS ON OUTCOME OF UNRELATED DONOR HEMATOPOIETIC STEM CELL TRANSPLANTATION

Aim: To study the various HLA high resolution typing mismatching of donor-recipient pairs impact to success of unrelated donor hematopoietic stem cell transplantation. Methods: 835 donor-recipient pairs of CMDP data were analyzed from 2005 to 2010. HLA-A, B, C, DRB1 and DQB1 typing were performed using SBT, SSOP and SSP. All the patients were undergoed transplantation for AML (n=288), ALL (n=227), CML (n=187), MDS (n=52), NHL (n=25) and AA (n=42). In the 835 donor-recipient pairs, 362 pairs were completely matched, 473 pairs were mismatched include of single allele and antigen, both allele and antigen, double allele and antigen, multiple allele and antigen. Results: HLA-matched pairs was associated with better overall survival compared with HLA-mismatched pairs (79.83% vs 73.15%), but there were no statistically significant differences. HLA mismatches of single allele plus single antigen were a significant risk factor for OS, DFS and TRM. In the patients of difference FAB groups, OS from high to low in turn was MA, AA, CML, MDS, AML, NHL, ALL. OS of HLA locus mismatching were DRB1(94.4%), DQB1(83.3%), B(75%), A(74.4%) and C(71.4%), respectively. OS of single allele mismatch at HLA locus from high to low in turn was DRB1, C, A, B and DQB1.HLA-A, B, C locus mismatch was statistically significant differences associated with lower OS and gradeII-IVacute GVHD compared with HLA-matched pairs. The donor-recipient pairs with HLA-B∗15:01/B∗15:05, DRB1∗12:01/DRB1∗12:02, C∗04:01/C∗03:04, DQB1∗03:02/DQB1∗03:03 alleles mismatch were priority accepted. But the donor-recipient pairs with HLA-B∗39:01/B∗39:05,C∗15:02/C∗14:02, C∗08:01/C∗03:04,C∗07:02/C∗15:02 alleles mismatch, were nonpermissive. These were risk factors to impact OS and the occurrence of severe aGVHD of HSCT. Conclusions: The high resolution typing for HLA-A, B, C, DRB1,DQB1 can be identified nonpermissive mismatch, that is would be beneficial for the selection of a suitable donor and can be improved higher rates of survival on unrelated donor HSCT. [Copyright &y& Elsevier]