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Donor HLA-E Status Associates with Disease-Free Survival and Transplant-Related Mortality after Non In Vivo T Cell-Depleted HSCT for Acute Leukemia
- Source :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Publication Year :
- 2019
-
Abstract
- Previous studies have suggested that HLA-E may have a significant role in the outcome of matched unrelated hematopoietic stem cell transplantation (HSCT), especially for patients with acute leukemia. We used Center for International Blood and Marrow Transplant Research data and samples of 1840 adult patients with acute leukemia and their 10/10 HLA-matched unrelated donors to investigate the impact of HLA-E matching status as well as of donor/recipient (D/R) HLA-E genotype on post-HSCT outcome. Both patients and donors were HLA-E genotyped by next-generation sequencing. All patients received their first transplant in complete remission between 2000 and 2015. Median follow-up time was 90 months. Overall survival, disease-free survival (DFS), transplant-related mortality (TRM), and relapse incidence were primary endpoints with statistical significance set at .01. D/R HLA-E genotype analysis revealed a significant association of donor HLA-E*01:03/01:03 genotype with DFS (hazard ratio [HR] = 1.35, P = .0006) and TRM (HR = 1.41, P = .0058) in patients who received T cell replete (ie, without in vivo T cell depletion) transplants (n = 1297). As for D/R HLA-E matching, we did not identify any significant effect on any of the clinical outcome endpoints. In conclusion, this is the largest study to date reporting an improvement of DFS and TRM after matched unrelated HSCT by avoidance of HLA-E*01:03 homozygous donors in patients transplanted with T cell replete grafts for acute leukemia.
- Subjects :
- Oncology
Adult
Male
medicine.medical_specialty
TRM
Adolescent
T cell
medicine.medical_treatment
Medizin
Hematopoietic stem cell transplantation
Human leukocyte antigen
DFS
Article
Disease-Free Survival
Lymphocyte Depletion
03 medical and health sciences
In vivo T cell depletion
0302 clinical medicine
Internal medicine
Genotype
Medicine
Humans
Aged
Transplantation
Acute leukemia
Donor HLA-E
Leukemia
business.industry
Incidence (epidemiology)
Hazard ratio
Histocompatibility Antigens Class I
Hematopoietic Stem Cell Transplantation
Hematology
Transplant-Related Mortality
Middle Aged
Allografts
3. Good health
Survival Rate
medicine.anatomical_structure
030220 oncology & carcinogenesis
Acute Disease
Unrelated HSCT
Female
Acute Leukemia
business
Unrelated Donors
030215 immunology
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....7e9e29eaa69a8f729b2dd4292879c1a6