Journal
JOURNAL OF CLINICAL ONCOLOGY
Volume 39, Issue 21, Pages 2397-+Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1200/JCO.20.03643
Keywords
-
Categories
Funding
- charity Anthony Nolan
- National Cancer Institute (NCI) [U24CA076518]
- National Heart, Lung and Blood Institute (NHLBI)
- National Institute of Allergy and Infectious Diseases (NIAID)
- NHLBI [U24HL138660, U01HL128568]
- NCI
- Health Resources and Services Administration (HRSA) [HHSH250201700006C, HHSH250201700007C]
- Office of Naval Research [N00014-20-1-2705, N00014-20-12832]
- BARDA
- Match Foundation
- Boston Children's Hospital
- Dana Farber
- St Baldrick's Foundation
- Stanford University
- Medical College of Wisconsin the National Marrow Donor Program
- Actinium Pharmaceuticals Inc.
- Adienne SA
- Allovir Inc.
- Amgen Inc.
- Angiocrine Bioscience
- Astellas Pharma US
- bluebird bio Inc.
- Bristol Myers Squibb Co
- Celgene Corp
- CSL Behring
- CytoSen Therapeutics Inc.
- Daiichi Sankyo Co, Ltd.
- ExcellThera
- Fate Therapeutics
- Gamida-Cell, Ltd.
- Genentech Inc.
- Incyte Corporation
- Janssen/Johnson Johnson
- Jazz Pharmaceuticals Inc.
- Kiadis Pharma
- Kite, a Gilead Company
- Kyowa Kirin
- Legend Biotech
- Magenta Therapeutics
- Merck Sharp Dohme Corp
- Millennium, the Takeda Oncology Co
- Miltenyi Biotec Inc.
- Novartis Pharmaceuticals Corporation
- Omeros Corporation
- Oncoimmune Inc.
- Orca Biosystems Inc.
- Pfizer Inc.
- Pharmacyclics, LLC
- Sanofi Genzyme
- Takeda Pharma
- Vor Biopharma
- Xenikos BV
- Stemcyte
- [P01CA111412]
- [R01CA152108]
- [R01CA215134]
- [R01CA218285]
- [R01CA231141]
- [R01AI128775]
- [R01HL126589]
- [R01HL129472]
- [R01HL130388]
- [R01HL131731]
- [U01AI069197]
- [U01AI126612]
- [UG1HL06924]
Ask authors/readers for more resources
This study found that UHR HLA matching may not increase overall survival probability, but it does reduce the risk of aGVHD and in certain subsets, transplant-related mortality. Matching at the UHR level warrants consideration when choosing between multiple 10 out of 10 HLA-matched donors.
PURPOSE Ultrahigh resolution (UHR) HLA matching is reported to result in better outcomes following unrelated donor hematopoietic cell transplantation, improving survival and reducing post-transplant complications. However, most studies included relatively small numbers of patients. Here we report the findings from a large, multicenter validation study. METHODS UHR HLA typing was available on 5,140 conventionally 10 out of 10 HLA-matched patients with malignant disease transplanted between 2008 and 2017. RESULTS After UHR HLA typing, 82% of pairs remained 10 out of 10 UHR-matched; 12.3% of patients were 12 out of 12 UHR HLA-matched. Compared with 12 out of 12 UHR-matched patients, probabilities of grade 2-4 acute graft-versus-host disease (aGVHD) were significantly increased with UHR mismatches (overall P = .0019) and in those patients who were HLA-DPB1 T-cell epitope permissively mismatched or nonpermissively mismatched (overall P = .0011). In the T-cell-depleted subset, the degree of UHR HLA mismatch was only associated with increased transplant-related mortality (TRM) (overall P = .0068). In the T-cell-replete subset, UHR HLA matching was associated with a lower probability of aGVHD (overall P = .0020); 12 out of 12 UHR matching was associated with reduced TRM risk when compared with HLA-DPB1 T-cell epitope permissively mismatched patients, whereas nonpermissive mismatching resulted in a greater risk (overall P = .0003). CONCLUSION This study did not confirm that UHR 12 out of 12 HLA matching increases the probability of overall survival but does demonstrate that aGVHD risk, and in certain settings TRM, is lowest in UHR HLA-matched pairs and thus warrants consideration when multiple 10 out of 10 HLA-matched donors of equivalent age are available.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available