title: Impact of a single human leucocyte antigen (HLA) allele mismatch on the outcome of unrelated bone marrow transplantation over two time periods. A retrospective analysis of 3003 patients from the HLA Working Group of the Japan Society for Blood and Marrow Transplantation.
abstract: A previous Japanese study revealed that a human leucocyte antigen (HLA)-A or -B allele mismatch was associated with higher overall mortality, whereas an HLA-C or -DRB1 allele mismatch did not affect mortality after serologically matched unrelated bone marrow transplantation (BMT). This study reanalysed 3003 adult patients who underwent unrelated BMT from a serologically HLA-A, -B, or -DR matched unrelated donor between 1993 and 2009 using the latest database, that included 1966 HLA-matched unrelated BMT and 187, 31, 524, and 295 unrelated BMT with a single HLA-A, -B, -C, or -DRB1 allele mismatch, respectively. As opposed to our previous findings, HLA-C and -DRB1 mismatches had a significant negative impact [hazard ratio (HR) 1·35, P < 0·001, and HR 1·45, P < 0·001] on survival in the period 2000-2009. The negative impact of each single HLA allele mismatch was not significantly different among the HLA-A, -B, -C, and -DRB1 mismatches (P = 0·79). An interaction test revealed that the effects of single HLA-C and -DRB1 allele mismatches significantly differed over the two time periods (P = 0·032 and P = 0·0072, respectively). In conclusion, the impact of a single HLA allele mismatch changed over time. In the recent cohort, the negative impact of HLA-DRB1 and -C mismatches became apparent.
authors: Division of Haematology, Saitama Medical Centre, Jichi Medical University, Saitama, Japan. ycanda-tky@umin.ac.jp
authors: Yoshinobu
authors: Y
authors: Kanda
authors: Junya
authors: J
authors: Kanda
authors: Yoshiko
authors: Y
authors: Atsuta
authors: Yoshinobu
authors: Y
authors: Maeda
authors: Tatsuo
authors: T
authors: Ichinohe
authors: Kazuteru
authors: K
authors: Ohashi
authors: Takahiro
authors: T
authors: Fukuda
authors: Koichi
authors: K
authors: Miyamura
authors: Hiroatsu
authors: H
authors: Iida
authors: Takehiko
authors: T
authors: Mori
authors: Koji
authors: K
authors: Iwato
authors: Tetsuya
authors: T
authors: Eto
authors: Keisei
authors: K
authors: Kawa
authors: Satoshi
authors: S
authors: Morita
authors: Yasuo
authors: Y
authors: Morishima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D016026:Bone Marrow Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006680:HLA Antigens / Q000235:genetics*; D019337:Hematologic Neoplasms / Q000235:genetics / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000235:genetics / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D006680:HLA Antigens