title: The impact of immunogenetics and clinical factors on the outcome of unrelated cord blood transplantation: the Milano Cord Blood Bank data.
abstract: In this article we examined the role of HLA incompatibility, of KIR C1 and C2 ligands and of other clinical factors on 99 cord blood transplants performed using single units from Milano Cord Blood Bank (MICB). We analyzed the occurrence of rejection, overall patient survival (OS) and occurrence of acute GvHD >or= 2 grade (severe aGvHD). No correlation was found between the end points and the number of HLA-A,-B, -DRB1 and -DQB1 mismatches. Only HLA-C disparities are associated with the occurrence of rejection (P=0.03). Our results showed that the presence of the C1 ligand in the donor decreased the occurrence of aGvHD (grade >or= 2) in the recipient while recipients of donors expressing the C2 KIR ligand experienced more frequently aGvHD (P=0.03). The HLA-C1 ligand, therefore, proved to have a protective effect towards severe aGvHD. The probability of rejection increased in KIR epitope-mismatched recipient/donor pairs (P=0.01). Finally the stage of disease at transplantation and cell dose were important for patient survival (P=0.003, P=0.048 respectively).
authors.affiliation: Organ and Tissue Transplantation Immunology, Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. marta.serafini@policlinico.mi.it
authors.forename: Marta
authors.initials: M
authors.lastname: Serafini
authors.forename: Francesca
authors.initials: F
authors.lastname: Poli
authors.forename: Rosanna
authors.initials: R
authors.lastname: Torelli
authors.forename: Katharina
authors.initials: K
authors.lastname: Fleischhauer
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Zino
authors.forename: Alejandro Espadas
authors.initials: AE
authors.lastname: de Arias
authors.forename: Elena
authors.initials: E
authors.lastname: Longhi
authors.forename: Sara
authors.initials: S
authors.lastname: Frison
authors.forename: Katherina
authors.initials: K
authors.lastname: Karpasitou
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pezzali
authors.forename: Lucilla
authors.initials: L
authors.lastname: Lecchi
authors.forename: Mario
authors.initials: M
authors.lastname: Scalamogna
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D005260:Female; D006086:Graft vs Host Disease / Q000235:genetics* / Q000276:immunology; D015236:HLA-C Antigens / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D008875:Middle Aged; D054340:Receptors, KIR / Q000235:genetics* / Q000276:immunology; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000009:adverse effects; D055815:Young Adult
chemical_list: D015236:HLA-C Antigens; D054340:Receptors, KIR