title: HLA-matched sibling transplantation for severe aplastic anemia: impact of HLA DR15 antigen status on engraftment, graft-versus-host disease, and overall survival.
abstract: The HLA class II DRB1 antigen DR15 (common alleles *1501, *1502) is an important marker in the pathobiology of severe aplastic anemia (SAA). We studied 1204 recipients of HLA-matched sibling bone marrow transplantation for SAA to determine whether HLA DR15 status (as determined by allele-level typing) affected hematopoietic recovery, graft-versus-host disease (GVHD), or overall survival (OS). In multivariate analysis, secondary graft failure rate at 2 years was lower in patients who were HLA DR15+ (hazard ratio = 0.46, P = .01). However, neutrophil recovery at day -28, platelet recovery at day -100, acute GVHD, chronic GVHD, and overall mortality were independent of DR15 status. The 5-year probabilities of OS, after adjusting for age, race, performance score, transplant-conditioning regimen, and year of transplantation, were 78% and 81% for patients who were HLA DR15+ and HLA DR15-, respectively (P = .35). In conclusion, DR15 status is associated with secondary graft failure after HLA-matched sibling bone marrow transplantation for SAA but has no significant impact on survival.
authors.affiliation: Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USA. minoo.battiwalla@nih.gov
authors.forename: Minoo
authors.initials: M
authors.lastname: Battiwalla
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Jeanette
authors.initials: J
authors.lastname: Carreras
authors.forename: H Joachim
authors.initials: HJ
authors.lastname: Deeg
authors.forename: Mouhab
authors.initials: M
authors.lastname: Ayas
authors.forename: Rajinder P S
authors.initials: RP
authors.lastname: Bajwa
authors.forename: Biju
authors.initials: B
authors.lastname: George
authors.forename: Vikas
authors.initials: V
authors.lastname: Gupta
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pasquini
authors.forename: Hubert
authors.initials: H
authors.lastname: Schrezenmeier
authors.forename: Jakob R
authors.initials: JR
authors.lastname: Passweg
authors.forename: Kirk R
authors.initials: KR
authors.lastname: Schultz
authors.forename: Mary
authors.initials: M
authors.lastname: Eapen
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D016026:Bone Marrow Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D059810:HLA-DR Serological Subtypes / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D035781:Siblings; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D059810:HLA-DR Serological Subtypes; C106559:HLA-DR15 antigen