title: Impact of the direction of HLA mismatch on transplantation outcomes in single unrelated cord blood transplantation.
abstract: The impact of the direction of HLA mismatch (MM) on outcome in unrelated cord blood (UCB) transplantation has not yet been clarified. We conducted a retrospective study using national registry data on 2977 patients who underwent transplantation using a single UCB for leukemia or myelodysplastic syndrome. HLA matching was assessed by serologic data for HLA-A, -B, and -DR loci. The median age of the recipients at transplantation was 41 years (range, 0-82 years), and 2300 recipients (77%) were age ≥16 years. The 2-year overall survival rate was 0.46. The presence of MM only in the graft-versus-host direction or only in the host-versus-graft direction was not associated with overall mortality (hazard ratio [HR], 0.88; P = .317 and HR, 0.95; P = .670, respectively) compared with 1 bidirectional MM. This finding was consistent in both the child and adult cohorts. The presence of MM only in the graft-versus-host direction was associated with a lower incidence of nonrelapse mortality (HR, 0.65; P = .040), significant only in the child cohort. No MM category was associated with relapse. Our findings suggest that the direction of HLA MM does not have a significant impact on overall survival after UCB transplantation.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Atsuta
authors.forename: Atsushi
authors.initials: A
authors.lastname: Wake
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ichinohe
authors.forename: Minoko
authors.initials: M
authors.lastname: Takanashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ogawa
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.forename: Yuju
authors.initials: Y
authors.lastname: Ohno
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Aotsuka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Onishi
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nagamura-Inoue
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens