title: Impact of HLA mismatch direction on outcomes after umbilical cord blood transplantation for hematological malignant disorders: a retrospective Eurocord-EBMT analysis.
abstract: HLA matching is a critical determinant of outcomes for patients who have undergone umbilical cord blood transplantation (UCBT). Data have been published on the importance of donor/recipient HLA mismatch direction on UCBT outcomes. HLA mismatch in the graft-versus-host (GVH) direction is defined as a donor homozygous at an HLA locus, while the recipient shares one HLA Ag with the donor. HLA mismatch in the host-versus-graft (HVG) direction is defined as a recipient homozygous with the donor sharing one HLA Ag. In our study we focused on confirming, using an independent population, whether transplantation outcomes would be different when HLA mismatch direction was considered. We analyzed 1565 patients who received a single-unit UCBT for malignant disease. Median age was 15 years and 72% of patients were transplanted for leukemia. In multivariate analysis, using the 5/6 HLA-matched population as reference, one or two HLA mismatches in the GVH or HVG direction were not associated with non-relapse related mortality and survival. On the basis of our results, there is no evidence to support a change in the current practice for cord blood unit selection.
authors: Eurocord, Hôpital Saint Louis, Paris, France.
authors: R
authors: R
authors: Cunha
authors: Service d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, AP-HP and Inserm UMRS940, Paris, France.
authors: P
authors: P
authors: Loiseau
authors: Eurocord, Hôpital Saint Louis, Paris, France.
authors: A
authors: A
authors: Ruggeri
authors: Hospital Universitario La Fe, Servicio de Hematologia, Valencia, Spain.
authors: G
authors: G
authors: Sanz
authors: Hôpital Timone-Enfants, Service Hématologie Pédiatrique, Marseille, France.
authors: G
authors: G
authors: Michel
authors: A P
authors: AP
authors: Iori
authors: Università La Sapienza, Department of Biotecnologie Cellulari ed Ematologia, Rome, Italy.
authors: A
authors: A
authors: Paolaiori
authors: Bone Marrow Transplant Unit, Hôpital Saint Louis, Paris, France.
authors: G
authors: G
authors: Socié
authors: Rome Transplant Network, Bone Marrow Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy.
authors: W
authors: W
authors: Arcese
authors: Rome Transplant Network, Bone Marrow Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy.
authors: A
authors: A
authors: Picardi
authors: Hospital Vall d'Hebron, Servicio de Hematologia Pediatrica, Barcelona, Spain.
authors: C
authors: C
authors: Dias de Heredia
authors: Hotel Dieu, Service Hématologie, Paris, France.
authors: B
authors: B
authors: Rio
authors: Dipartimento di Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, IRCCS Ospedale Bambino Gesù and University of Pavia, Rome, Italy.
authors: F
authors: F
authors: Locatelli
authors: Cord & Marrow Transplant Program, Sydney Children's Hospital, Sydney, Australia.
authors: T A
authors: TA
authors: O'Brien
authors: Hôpital Claude Huriez, Service Hématologie, Lille, France.
authors: I
authors: I
authors: Yakoub-Agha
authors: Jesus Children's Hospital, Madrid, Spain.
authors: M
authors: M
authors: Angel Diaz
authors: CHU Bordeaux, Service Hématologie, Pessac, France.
authors: N
authors: N
authors: Milpied
authors: Ste-Justine Hospital, Pediatric Hematology Unit, Montreal, Canada.
authors: H
authors: H
authors: Bittencourt
authors: Hospital Amaral Carvalho, Bone Marrow Transplant Unit, Jau, Brazil.
authors: M
authors: M
authors: Pedro Souza
authors: King Faisal Specialist Hospital & Research Centre, Bone Marrow Transplant Unit, Ryad, Saudi Arabia.
authors: M
authors: M
authors: Aljurf
authors: Service d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, AP-HP and Inserm UMRS940, Paris, France.
authors: D
authors: D
authors: Charron
authors: Eurocord, Hôpital Saint Louis, Paris, France.
authors: K
authors: K
authors: Boudjedir
authors: Acute Leukemia Working Party of the European Blood and Marrow Transplant Group, Hôpital Saint Antoine, Université de Paris 7, Service Hématologie, Paris, France.
authors: M
authors: M
authors: Labopin
authors: Eurocord, Hôpital Saint Louis, Paris, France.
authors: E
authors: E
authors: Gluckman
authors: 1] Eurocord, Hôpital Saint Louis, Paris, France [2] Churchill Hospital, Hematology Unit, University of Oxford, Oxford, UK.
authors: V
authors: V
authors: Rocha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease; D006680:HLA Antigens / Q000737:chemistry / Q000276:immunology*; D019337:Hematologic Neoplasms / Q000276:immunology* / Q000628:therapy*; D006648:Histocompatibility / Q000276:immunology*; D006650:Histocompatibility Testing; D006720:Homozygote; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000166:cytology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens
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