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Effect of HLA class I or class II incompatibility in pediatric marrow transplantation from unrelated and related donors.
- Source :
-
Human immunology [Hum Immunol] 2001 Apr; Vol. 62 (4), pp. 399-407. - Publication Year :
- 2001
-
Abstract
- The degree of histoincompatibility that can be tolerated, and the relative importance of matching at individual HLA class I and class II locus in bone marrow transplantation (BMT) has not been established. We hypothesized that matching for HLA-DR may not be more important than matching for HLA-A or HLA-B in selection of a donor for successful BMT. We retrospectively analyzed the outcomes of 248 consecutive pediatric patients who received allogeneic BMT from related donors (RD, n = 119) or unrelated donors (URD, n = 129). HLA-A and HLA-B were serologically matched, and HLA-DRB1 were identical by DNA typing in 69% of donor-recipient pairs. Most patients (89%) had hematologic malignancies; the rest had aplastic anemia or a congenital disorder. One HLA-A antigen mismatch was associated with a decrease in survival (p = 0.003) and a delay in granulocyte engraftment (p = 0.02) in recipients of RD marrow; as well as a decrease in survival (p = 0.02) and the development of severe acute graft-versus-host disease (GVHD) (p = 0.03) in recipients of URD marrow. One HLA-B antigen mismatch was associated with a decrease in the survival (p = 0.05) and the development of severe GVHD (p = 0.0007) in recipients of RD marrow. One HLA-DRB1 allele mismatch was associated only with a decrease in the survival (p = 0.0003) of recipients of RD marrow. Results of this study suggest that disparity in HLA-A and HLA-B antigens may not be better tolerated than disparity in HLA-DR allele in allogeneic BMT. Further studies are warranted to confirm our results.
- Subjects :
- Acute Disease
Adolescent
Adult
Child
Child, Preschool
Female
Graft vs Host Disease immunology
HLA-DRB1 Chains
Humans
Infant
Male
Pediatrics
Recurrence
Retrospective Studies
Survivors
Tissue Donors
Treatment Outcome
Blood Group Incompatibility immunology
Bone Marrow Transplantation immunology
HLA-A Antigens immunology
HLA-B Antigens immunology
HLA-DR Antigens immunology
Subjects
Details
- Language :
- English
- ISSN :
- 0198-8859
- Volume :
- 62
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Human immunology
- Publication Type :
- Academic Journal
- Accession number :
- 11295473
- Full Text :
- https://doi.org/10.1016/s0198-8859(01)00220-8