期刊
BRITISH JOURNAL OF HAEMATOLOGY
卷 161, 期 4, 页码 566-577出版社
WILEY
DOI: 10.1111/bjh.12279
关键词
allogeneic haematopoietic stem cell transplantation; human leucocyte antigen; graft-versus-host disease; human leucocyte antigen mismatch; unrelated donor
类别
资金
- Ministry of Health, Labour and Welfare of Japan
A previous Japanese study revealed that a human leucocyte antigen (HLA)-A or -B allele mismatch was associated with higher overall mortality, whereas an HLA-C or -DRB1 allele mismatch did not affect mortality after serologically matched unrelated bone marrow transplantation (BMT). This study reanalysed 3003 adult patients who underwent unrelated BMT from a serologically HLA-A, -B, or -DR matched unrelated donor between 1993 and 2009 using the latest database, that included 1966 HLA-matched unrelated BMT and 187, 31, 524, and 295 unrelated BMT with a single HLA-A, -B, -C, or -DRB1 allele mismatch, respectively. As opposed to our previous findings, HLA-C and -DRB1 mismatches had a significant negative impact [hazard ratio (HR) 1 center dot 35, P<0 center dot 001, and HR 1 center dot 45, P<0 center dot 001] on survival in the period 20002009. The negative impact of each single HLA allele mismatch was not significantly different among the HLA-A, -B, -C, and -DRB1 mismatches (P=0 center dot 79). An interaction test revealed that the effects of single HLA-C and -DRB1 allele mismatches significantly differed over the two time periods (P=0 center dot 032 and P=0 center dot 0072, respectively). In conclusion, the impact of a single HLA allele mismatch changed over time. In the recent cohort, the negative impact of HLA-DRB1 and -C mismatches became apparent.
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