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. Sanz; Eliane Gluckman; Vanderson Rocha

doi:10.1182/blood-2013-05-506253

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

Ospedale Pediatrico Bambino Gesu

Research output: Contribution to journal › Article › peer-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 language	English
Pages (from-to)	133-140
Number of pages	8
Journal	Blood
Volume	123
Issue number	1
DOIs	https://doi.org/10.1182/blood-2013-05-506253
Publication status	Published - Jan 2 2014

ASJC Scopus subject areas

Hematology
Biochemistry
Cell Biology
Immunology

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Eapen, M., Klein, J. P., Ruggeri, A., Spellman, S., Lee, S. J., Anasetti, C., Arcese, W., Barker, J. N., Lee, A. B. L., Brown, M., Fernandez-Vina, M. A., Freeman, J., He, W., Iori, A. P., Horowitz, M. M., Locatelli, F., Marino, S., Maiers, M., Michel, G., ... Rocha, V. (2014). Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy. Blood, 123(1), 133-140. https://doi.org/10.1182/blood-2013-05-506253

Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy. / Eapen, Mary; Klein, John P.; Ruggeri, Annalisa; Spellman, Stephen; Lee, Stephanie J.; Anasetti, Claudio; Arcese, William; Barker, Juliet N.; Lee, Ann Baxter Lowe; Brown, Maria; Fernandez-Vina, Marcelo A.; Freeman, John; He, Wensheng; Iori, Anna Paola; Horowitz, Mary M.; Locatelli, Franco; Marino, Susana; Maiers, Martin; Michel, Gerard; Sanz, Guillermo F.; Gluckman, Eliane; Rocha, Vanderson.

In: Blood, Vol. 123, No. 1, 02.01.2014, p. 133-140.

Research output: Contribution to journal › Article › peer-review

Eapen, M, Klein, JP, Ruggeri, A, Spellman, S, Lee, SJ, Anasetti, C, Arcese, W, Barker, JN, Lee, ABL, Brown, M, Fernandez-Vina, MA, Freeman, J, He, W, Iori, AP, Horowitz, MM, Locatelli, F, Marino, S, Maiers, M, Michel, G, Sanz, GF, Gluckman, E & Rocha, V 2014, 'Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy', Blood, vol. 123, no. 1, pp. 133-140. https://doi.org/10.1182/blood-2013-05-506253

Eapen, Mary ; Klein, John P. ; Ruggeri, Annalisa ; Spellman, Stephen ; Lee, Stephanie J. ; Anasetti, Claudio ; Arcese, William ; Barker, Juliet N. ; Lee, Ann Baxter Lowe ; Brown, Maria ; Fernandez-Vina, Marcelo A. ; Freeman, John ; He, Wensheng ; Iori, Anna Paola ; Horowitz, Mary M. ; Locatelli, Franco ; Marino, Susana ; Maiers, Martin ; Michel, Gerard ; Sanz, Guillermo F. ; Gluckman, Eliane ; Rocha, Vanderson. / Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy. In: Blood. 2014 ; Vol. 123, No. 1. pp. 133-140.

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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).",

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AU - Lee, Stephanie J.

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AU - Fernandez-Vina, Marcelo A.

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AU - He, Wensheng

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AU - Horowitz, Mary M.

AU - Locatelli, Franco

AU - Marino, Susana

AU - Maiers, Martin

AU - Michel, Gerard

AU - Sanz, Guillermo F.

AU - Gluckman, Eliane

AU - Rocha, Vanderson

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N2 - 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).

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