Abstract
The importance of HLA donor-recipient matching in unrelated haematopoietic SCT (HSCT) is the subject of debate. In this retrospective study, we analyzed 805 adult patients from the Italian Registry receiving HSCT for a haematological malignancy from January 1999 to June 2006 and correlated the degree of HLA matching with transplant outcome. All patient-donor pairs had high-resolution typing at HLA-A, -B, -C, -DRB1 and -DQB1. There was a significantly higher risk of overall mortality, non-relapse mortality, graft failure and acute GVHD (aGVHD) for patients receiving HSCT from an unrelated donor with one or more low- or high-resolution mismatch/es (Mm/s). When only a single HLA Mm is present (9/10 matched pairs), mortality risk is higher than among 10/10 matched pairs in patients transplanted with acute leukaemia in the first CR ('early' patients) but not in the other patients (advanced patients): HR = 1.69, 95% CI = 0.94-3.02, P = 0.08; HR = 1.03, 95% CI = 0.80-1.32, P = 0.82, for early and advanced patients, respectively. These results confirm that the advantage of a 10/10 match has a greater effect in early patients, thus suggesting that a 9/10 matched donor can be chosen in patients with advanced disease lacking a rapidly available 10/10 matched one.
| Original language | English |
|---|---|
| Pages (from-to) | 571-577 |
| Number of pages | 7 |
| Journal | Bone Marrow Transplantation |
| Volume | 44 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2009 |
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ASJC Scopus subject areas
- Hematology
- Transplantation
Cite this
HLA matching affects clinical outcome of adult patients undergoing haematopoietic SCT from unrelated donors : A study from the Gruppo Italiano Trapianto di Midollo Osseo and Italian Bone Marrow Donor Registry. / Crocchiolo, R.; Ciceri, F.; Fleischhauer, K.; Oneto, R.; Bruno, B.; Pollichieni, S.; Sacchi, N.; Sormani, M. P.; Fanin, R.; Bandini, G.; Bonifazi, F.; Bosi, A.; Rambaldi, A.; Alessandrino, P. E.; Falda, M.; Bacigalupo, A.
In: Bone Marrow Transplantation, Vol. 44, No. 9, 2009, p. 571-577.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - HLA matching affects clinical outcome of adult patients undergoing haematopoietic SCT from unrelated donors
T2 - A study from the Gruppo Italiano Trapianto di Midollo Osseo and Italian Bone Marrow Donor Registry
AU - Crocchiolo, R.
AU - Ciceri, F.
AU - Fleischhauer, K.
AU - Oneto, R.
AU - Bruno, B.
AU - Pollichieni, S.
AU - Sacchi, N.
AU - Sormani, M. P.
AU - Fanin, R.
AU - Bandini, G.
AU - Bonifazi, F.
AU - Bosi, A.
AU - Rambaldi, A.
AU - Alessandrino, P. E.
AU - Falda, M.
AU - Bacigalupo, A.
PY - 2009
Y1 - 2009
N2 - The importance of HLA donor-recipient matching in unrelated haematopoietic SCT (HSCT) is the subject of debate. In this retrospective study, we analyzed 805 adult patients from the Italian Registry receiving HSCT for a haematological malignancy from January 1999 to June 2006 and correlated the degree of HLA matching with transplant outcome. All patient-donor pairs had high-resolution typing at HLA-A, -B, -C, -DRB1 and -DQB1. There was a significantly higher risk of overall mortality, non-relapse mortality, graft failure and acute GVHD (aGVHD) for patients receiving HSCT from an unrelated donor with one or more low- or high-resolution mismatch/es (Mm/s). When only a single HLA Mm is present (9/10 matched pairs), mortality risk is higher than among 10/10 matched pairs in patients transplanted with acute leukaemia in the first CR ('early' patients) but not in the other patients (advanced patients): HR = 1.69, 95% CI = 0.94-3.02, P = 0.08; HR = 1.03, 95% CI = 0.80-1.32, P = 0.82, for early and advanced patients, respectively. These results confirm that the advantage of a 10/10 match has a greater effect in early patients, thus suggesting that a 9/10 matched donor can be chosen in patients with advanced disease lacking a rapidly available 10/10 matched one.
AB - The importance of HLA donor-recipient matching in unrelated haematopoietic SCT (HSCT) is the subject of debate. In this retrospective study, we analyzed 805 adult patients from the Italian Registry receiving HSCT for a haematological malignancy from January 1999 to June 2006 and correlated the degree of HLA matching with transplant outcome. All patient-donor pairs had high-resolution typing at HLA-A, -B, -C, -DRB1 and -DQB1. There was a significantly higher risk of overall mortality, non-relapse mortality, graft failure and acute GVHD (aGVHD) for patients receiving HSCT from an unrelated donor with one or more low- or high-resolution mismatch/es (Mm/s). When only a single HLA Mm is present (9/10 matched pairs), mortality risk is higher than among 10/10 matched pairs in patients transplanted with acute leukaemia in the first CR ('early' patients) but not in the other patients (advanced patients): HR = 1.69, 95% CI = 0.94-3.02, P = 0.08; HR = 1.03, 95% CI = 0.80-1.32, P = 0.82, for early and advanced patients, respectively. These results confirm that the advantage of a 10/10 match has a greater effect in early patients, thus suggesting that a 9/10 matched donor can be chosen in patients with advanced disease lacking a rapidly available 10/10 matched one.
UR - http://www.scopus.com/inward/record.url?scp=70749142248&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70749142248&partnerID=8YFLogxK
U2 - 10.1038/bmt.2009.67
DO - 10.1038/bmt.2009.67
M3 - Article
C2 - 19363528
AN - SCOPUS:70749142248
VL - 44
SP - 571
EP - 577
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
IS - 9
ER -