title: Marrow transplantation from unrelated donors for treatment of hematologic malignancies: effect of mismatching for one HLA locus.
abstract: One hundred twelve patients less than 36 years old received marrow grafts from unrelated donors as treatment for hematologic malignancy. Seventy donor/recipient pairs were phenotypically identical for HLA-A, -B, and -D, while 42 had a "minor" disparity at one HLA locus. There was an increase in the risk of acute graft-versus-host disease (GVHD) in patients receiving HLA-partially matched grafts compared with those receiving HLA-matched grafts (51% v 36% probability of grades III-IV acute GVHD). However, in this cohort of patients, there was no significant difference in survival (at 1.5 years, 46% v 51% for good-risk patients, 44% v 30% for poor-risk patients). This finding suggests that some degree of HLA disparity can be tolerated in young patients transplanted from unrelated donors for malignant disease, thus making transplantation an option available to larger numbers of patients.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle.
authors.forename: P G
authors.initials: PG
authors.lastname: Beatty
authors.forename: C
authors.initials: C
authors.lastname: Anasetti
authors.forename: J A
authors.initials: JA
authors.lastname: Hansen
authors.forename: G M
authors.initials: GM
authors.lastname: Longton
authors.forename: J E
authors.initials: JE
authors.lastname: Sanders
authors.forename: P J
authors.initials: PJ
authors.lastname: Martin
authors.forename: E M
authors.initials: EM
authors.lastname: Mickelson
authors.forename: S Y
authors.initials: SY
authors.lastname: Choo
authors.forename: E W
authors.initials: EW
authors.lastname: Petersdorf
authors.forename: M S
authors.initials: MS
authors.lastname: Pepe
mesh_terms: D000208:Acute Disease; D000328:Adult; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000276:immunology; D006680:HLA Antigens / Q000032:analysis*; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors
chemical_list: D006680:HLA Antigens