Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy

Mary Eapen, John P. Klein, Annalisa Ruggeri, Stephen Spellman, Stephanie J. Lee, Claudio Anasetti, William Arcese, Juliet N. Barker, Ann Baxter Lowe Lee, Maria Brown, Marcelo A. Fernandez-Vina, John Freeman, Wensheng He, Anna Paola Iori, Mary M. Horowitz, Franco Locatelli, Susana Marino, Martin Maiers, Gerard Michel, Guillermo F. SanzEliane Gluckman, Vanderson Rocha

Research output: Contribution to journalArticlepeer-review

Abstract

We studied the effect of allele-level matching at human leukocyte antigen (HLA)-A, -B, -C, and -DRB1 in 1568 single umbilical cord blood (UCB) transplantations for hematologic malignancy. The primary end point was nonrelapse mortality (NRM). Only 7% of units were allele matched at HLA-A, -B, -C, and -DRB1; 15% were mismatched at 1, 26% at 2, 30% at 3, 16% at 4, and 5% at 5 alleles. In a subset, allele-level HLA match was assigned using imputation; concordance between HLA-match assignment and outcome correlation was confirmed between the actual and imputed HLA-match groups. Compared with HLA-matched units, neutrophil recovery was lower with mismatches at 3, 4, or 5, but not 1 or 2 alleles.NRM was higher with units mismatched at 1, 2, 3, 4, or 5 alleles compared with HLAmatched units. The observed effects are independent of cell dose and patient age. These data support allele-levelHLAmatching in the selection of single UCB units. (Blood. 2014;123(1):133-140).

Original languageEnglish
Pages (from-to)133-140
Number of pages8
JournalBlood
Volume123
Issue number1
DOIs
Publication statusPublished - Jan 2 2014

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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