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Protective effect of HLA-DPB1 mismatch remains valid in reduced-intensity conditioning unrelated donor hematopoietic cell transplantation.
Malki, Monzr M Al; Gendzekhadze, Ketevan; Stiller, Tracey; Mokhtari, Sally; Karanes, Chatchada; Parker, Pablo; Snyder, David; Forman, Stephen J; Nakamura, Ryotaro; Nademanee, Auayporn.
Afiliação
  • Malki MMA; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA. malmalki@coh.org.
  • Gendzekhadze K; HLA Laboratory, City of Hope, Duarte, CA, USA.
  • Stiller T; Division of Biostatistics, Department of Information Sciences, City of Hope, Duarte, CA, USA.
  • Mokhtari S; Department of Clinical Translational Program Development, City of Hope, Duarte, CA, USA.
  • Karanes C; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.
  • Parker P; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.
  • Snyder D; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.
  • Forman SJ; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.
  • Nakamura R; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.
  • Nademanee A; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.
Bone Marrow Transplant ; 55(2): 409-418, 2020 02.
Article em En | MEDLINE | ID: mdl-31551519
A mismatch at HLA-DPB1 locus is associated with higher acute GVHD and lower relapse rate after myeloablative (MAC) allogeneic hematopoietic cell transplantation (alloHCT). Also, in MAC setting, mismatch permissiveness and expression level impact alloHCT outcomes. However, in reduced intensity conditioning (RIC), DP mismatch effect on transplant outcomes is unknown. We retrospectively evaluated DP mismatch influence (number, permissiveness, and expression) on HCT outcomes in 310 patients with high-resolution typing (HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1), who underwent RIC HCT. By multivariable analysis, 11/12 had better overall survival (OS) and relapse vs. 12/12 (HR = 1.61 and 2.02; p = 0.04 and 0.01, respectively) and better OS vs. 10/12 (HR = 1.68; p = 0.02). Within the 11/12, nonpermissive (NoPR) mismatch was associated with higher risk of grade II-IV acute GVHD (HR = 1.97; p = 0.005) and nonrelapse mortality (HR = 2.13; p = 0.02) vs. permissive (PR). Grouping 11/12 based on the DP expression conferred higher mortality (HR = 3.78; p = 0.003) when low expressers received a graft from high expressers (AG) vs. low expressers (AA). Better OS was achieved in PR 11/12, when expression was low in patient and donor (AA) vs. all other combinations. Therefore, in RIC HCT, a single-DP mismatch has a protective role, especially in permissive setting, when donor and recipient are low expressers.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Células-Tronco Hematopoéticas / Doença Enxerto-Hospedeiro Tipo de estudo: Observational_studies Limite: Humans Idioma: En Revista: Bone Marrow Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Células-Tronco Hematopoéticas / Doença Enxerto-Hospedeiro Tipo de estudo: Observational_studies Limite: Humans Idioma: En Revista: Bone Marrow Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido