High-resolution HLA typing by sequencing for HLA-A, -B, -C, -DR, -DQ in 122 unrelated cord blood/patient pair transplants hardly improves long-term clinical outcome.
To determine the impact of high-resolution (HR) HLA typing with outcomes after UCBT, DNAs of 122 pairs were analysed for HLA class I and class II mismatches (MM) based on HR typing. For HLA-A, -B on low-resolution typing and -DRB1 on HR typing, the following MM situation resulted: no MM (13%), one MM (40%), two MM (36%), three MM (8%), four MM (3%). For A, B, C, DR and DQ based on HR typing the following MM occurred: No MM (4%), one MM (10%), two MM (15%), three MM (22%), four MM (25%), five MM (12%), six MM (6%), seven MM (3%), eight MM (2%). There was no significant association between number of MM (HR) for both HLA-A, -B and -DRB1 and HLA-A, -B, -C, -DRB1 and DQB1 and aGvHD grade II-IV. There was a trend that MM in class I HR were associated with neutrophil recovery; HLA-A locus typing analysed in HvG direction was associated with reduced cumulative incidence of engraftment (P=0.04), the same for C-KIR in HvG direction (P=0.01). No significant correlation was found between numbers of HLA-MM on the HR level with 2-year survival. The analysis shows that the degree of mismatching in UCBT is even higher than expected.
Kögler
G
G
José Carreras EUROCORD/NETCORD Bank Germany at the Institute for Transplantation Diagnostics and Cell Therapeutics, University of Duesseldorf Medical School, Düsseldorf, Germany. koegler@itz.uni-dusseldorf.de
Enczmann
J
J
Rocha
V
V
Gluckman
E
E
Wernet
P
P
D000017:ABO Blood-Group System; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D003587:Cytomegalovirus / Q000235:genetics; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D006086:Graft vs Host Disease; D006680:HLA Antigens / Q000096:biosynthesis / Q000737:chemistry*; D015234:HLA-A Antigens / Q000737:chemistry; D015235:HLA-B Antigens / Q000737:chemistry; D015236:HLA-C Antigens / Q000737:chemistry; D006683:HLA-DQ Antigens / Q000737:chemistry; D006684:HLA-DR Antigens / Q000737:chemistry; D006412:Hematopoietic Stem Cells / Q000166:cytology; D006650:Histocompatibility Testing; D006801:Humans; D016130:Immunophenotyping / Q000379:methods*; D007223:Infant; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D013997:Time Factors; D019172:Transplantation Conditioning; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D006680:HLA Antigens; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D015236:HLA-C Antigens; D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens