Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 17, Issue 6, Pages 923-929Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2010.10.017
Keywords
Hematopoietic stem cell transplantation; HLA matched unrelated donors; 9/10 matched related donors; Class I HLA mismatch; Class II HLA mismatch
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Funding
- NCI NIH HHS [P30 CA016672] Funding Source: Medline
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Most candidates for hematopoietic stem cell transplantation (HSCT) lack a human leukocyte antigen (HLA)identical sibling donor. Some patients may have a related donor with whom they are mismatched at I antigen/allele. It is not known whether such a match is preferable to a matched unrelated donor (MUD). We evaluated the outcomes (survival, relapse, nonrelapse mortality [NRM]) of all 28 patients with a single H LA antigen/allele mismatch identified through high-resolution HLA typing at HLA-A, -B, -C, -DRB1, and -DQB1, and all 318 patients with myeloid malignancies who received transplants from a 10/10 MUD treated during the same period of time at a single institution. Overall, outcomes for patients treated from a 1-antigen/allele mismatch related donor were significantly worse than from a MUD, primarily because of increased NRM. Overall survival (OS) rates at 3 years for 1-antigen/allele mismatched related donor and MUD transplant recipients were 19% and 45% (P = .007), and NRM rates were 40% and 26% (P = .05), respectively. Patients with class I mismatches appeared to have poorer OS than did patients with class II mismatches. A higher incidence of graft rejection was identified in the mismatched related donor group (P = .02). These results indicate that transplant outcomes are better with a MUD than with a 1 antigen/allele-mismatched related donor. Biol Blood Marrow Transplant 17: 923-929 (2011) (C) 2011 American Society for Blood and Marrow Transplantation
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