The Impact of High-resolution HLA-A, HLA-B, HLA-C, and HLA-DRB1 on Transplant-related Outcomes in Single-unit Umbilical Cord Blood Transplantation in Pediatric Patients.
J Pediatr Hematol Oncol
; 39(1): 26-32, 2017 01.
Article
de En
| MEDLINE
| ID: mdl-27820121
ABSTRACT
Current practice for selecting donor units for umbilical cord blood transplant (UCBT) involves matching at HLA-A and HLA-B by low-resolution typing and the HLA-DRB1 allele by high-resolution (HR) typing. We retrospectively studied the impact of HR allele matching at HLA-A, HLA-B, HLA-C, and HLA-DRB1 on transplant-related outcomes in 60 single-unit UCBTs in pediatric patients with malignant and nonmalignant conditions. Five-year overall survival of our cohort was 71% (95% confidence interval, 58-81); 27% experienced primary graft failure. Applying HR typing, donor-recipient mismatch variability increased ranging from 1/8 to 8/8, however, no impact on primary graft failure, graft-versus-host disease or posttransplant infection was observed. UCBTs with ≥6/8 HR matches did have a better overall survival (P=0.04) and decreased transplant-related mortality (P=0.02) compared with <6/8 HR matches. Using standard HLA typing, we showed an increased incidence of acute graft-versus-host disease (grade II to IV) and decreased transplant-related mortality in comparing the matched (6/6) versus ≤5/6 group (P=0.05 and 0.05, respectively). These data support the use of current guidelines for umbilical cord blood selection and encourage utilization of HR typing to select umbilical cord blood units matched at ≥6/8 especially when appropriate ≥5/6 units are available.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Test d'histocompatibilité
/
Transplantation de cellules souches de sang du cordon
/
Chaines HLA-DRB1
/
Antigènes HLA
Type d'étude:
Etiology_studies
/
Guideline
/
Observational_studies
/
Risk_factors_studies
Langue:
En
Journal:
J Pediatr Hematol Oncol
Sujet du journal:
HEMATOLOGIA
/
NEOPLASIAS
/
PEDIATRIA
Année:
2017
Type de document:
Article
Pays d'affiliation:
Israël