RESUMO
A novel HLA-B allele, B*39:93, was identified in a French family.
Assuntos
Alelos , Antígenos HLA-B/genética , Tipagem Molecular , Sequência de Bases , Éxons , Família , Feminino , França , Humanos , Masculino , Dados de Sequência Molecular , Alinhamento de SequênciaRESUMO
In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) set up the third annual series of workshops which brought together practitioners from all member centers and took place in October 2012 in Lille. Here we report our results and recommendations regarding the choice of optimal unrelated cord blood unit in terms of cell dose, HLA-matching and other characteristics.
Assuntos
Transplante de Células-Tronco de Sangue do Cordão Umbilical/normas , Sangue Fetal/transplante , Transplante de Células-Tronco Hematopoéticas/normas , Doadores não Relacionados , Volume Sanguíneo , Comportamento de Escolha , Transplante de Células-Tronco de Sangue do Cordão Umbilical/métodos , França , Transplante de Células-Tronco Hematopoéticas/métodos , Histocompatibilidade , Humanos , Transplante HomólogoAssuntos
Éxons/genética , Antígenos HLA-C/genética , Transplante de Células-Tronco Hematopoéticas , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Sequência de Bases , França , Histocompatibilidade , Teste de Histocompatibilidade , Humanos , Dados de Sequência Molecular , Polimorfismo de Nucleotídeo Único , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Alinhamento de Sequência , TransplanteRESUMO
HLA-B*07:305 differs from HLA-B*07:02:01:01 by one nucleotide substitution at position 255.
Assuntos
Alelos , Antígeno HLA-B7/genética , Teste de Histocompatibilidade/métodos , Análise de Sequência de DNA , Sequência de Bases , Éxons/genética , Humanos , Alinhamento de SequênciaRESUMO
HLA-C*16:116 differs from HLA-C*16:01:01:01 by single-nucleotide substitution at position 30.
Assuntos
Alelos , Antígenos HLA-C/genética , Teste de Histocompatibilidade/métodos , Análise de Sequência de DNA , Sequência de Bases , Éxons/genética , Humanos , Alinhamento de SequênciaRESUMO
HLA-A*24:391 differs from HLA-A*24:02:01:01 by one nucleotide substitution at position 33.
Assuntos
Alelos , Antígenos HLA-A/genética , Teste de Histocompatibilidade/métodos , Sequência de Bases , Éxons/genética , HumanosRESUMO
The monitoring of the minimal residual disease by Wilms' tumor 1 expression (MRDWT1) is a standardized test, which can be used in over 80% of patients with AML. To investigate the prognostic value of MRDWT1 in patients undergoing allogeneic stem cell transplantation (allo-SCT) for AML, MRDWT1 was monitored 3 months after transplantation in 139 patients. MRDWT1 positivity did not lead to any therapeutic intervention. Median follow-up was 39.3 (6.4-99.8) months. Patients with positive MRDWT1 at 3 months experienced more often post-transplant relapse (27/30, 90%) than those with negative MRDWT1 (16/109, 14.7%) (P<0.0001). Similarly, a shorter 3-year event-free survival (EFS) was observed in MRDWT1-positive patients (10% vs 72.3% in MRDWT1-negative patients, P<0.0001). The correlation between relapse and MRDWT1 was stronger in blood than in bone marrow samples. Multivariate analysis confirmed the detrimental role of 3-month positive MRDWT1 for relapse (hazard ratio (HR): 15.42; 95% confidence interval (CI): 7.53-31.59; P<0.0001) and EFS (HR: 10.71; 95% CI: 5.41-21.21; P<0.0001). Interestingly, 3-month chimerism was less predictive of relapse than positive MRDWT1. In conclusion, our results demonstrate the usefulness of peripheral blood MRDWT1 monitoring in identifying very high-risk patients, who could benefit from an early preemptive treatment, and those who do not need such an intervention.
Assuntos
Transplante de Células-Tronco Hematopoéticas/mortalidade , Leucemia Mieloide Aguda/terapia , Neoplasia Residual/diagnóstico , Proteínas WT1/análise , Medula Óssea/química , Intervalo Livre de Doença , Feminino , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/patologia , Masculino , Prognóstico , Recidiva , Transplante Homólogo , Resultado do Tratamento , Proteínas WT1/sangue , Tumor de Wilms/químicaRESUMO
We have conducted a retrospective study on 251 patients from three centers in France and Switzerland between 2004 and 2010 with the goal to evaluate the impact of HLA-DRB3/B4/B5 allele mismatching after HLA-10/10-matched unrelated allogeneic hematopoietic stem cell transplantation (HSCT). Fourteen (5.5%) patients receiving HSCT from an HLA-10/10-matched unrelated donor had a mismatched DRB4 donor, 23 (9.5%) patients had a mismatched DRB3 donor and 214 (85%) had a fully matched unrelated donor (HLA-10/10) without DRB3- or DRB4-mismatched donor. We compared the outcomes of 37 patients with a DRB3 or DRB4 mismatch with the rest of the population. The median survival for a patient without DRB3/4 mismatch was 18 months (95% confidence interval (CI), 13-29), for DRB3-mismatched patients 32 months (95% CI, 13-NR) and for DRB4-mismatched patients 7 months (95% CI, 3-NR). The multivariate analysis showed a significant impact of DRB4 mismatching on survival (Hazards ratio (HR)=2.1 (95% CI, 1.01-4.67), P=0.045), acute GvHD (HR=2.66 (95% CI, 0.99-7.09) P=0.05) and on transplant-related mortality (HR=2.8; (95% CI, 1.7-4.4) P=0.024). In the view of an impact of DRB4 locus mismatch on clinical outcome, it would be important to confirm this observation in a prospective study as it may be worth considering DRB4 in the unrelated donor selection.