title: Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy.
abstract: We studied the effect of allele-level matching at human leukocyte antigen (HLA)-A, -B, -C, and -DRB1 in 1568 single umbilical cord blood (UCB) transplantations for hematologic malignancy. The primary end point was nonrelapse mortality (NRM). Only 7% of units were allele matched at HLA-A, -B, -C, and -DRB1; 15% were mismatched at 1, 26% at 2, 30% at 3, 16% at 4, and 5% at 5 alleles. In a subset, allele-level HLA match was assigned using imputation; concordance between HLA-match assignment and outcome correlation was confirmed between the actual and imputed HLA-match groups. Compared with HLA-matched units, neutrophil recovery was lower with mismatches at 3, 4, or 5, but not 1 or 2 alleles. NRM was higher with units mismatched at 1, 2, 3, 4, or 5 alleles compared with HLA-matched units. The observed effects are independent of cell dose and patient age. These data support allele-level HLA matching in the selection of single UCB units.
authors.affiliation: Center for International Blood and Marrow Transplant Research.
authors.forename: Mary
authors.initials: M
authors.lastname: Eapen
authors.forename: John P
authors.initials: JP
authors.lastname: Klein
authors.forename: Annalisa
authors.initials: A
authors.lastname: Ruggeri
authors.forename: Stephen
authors.initials: S
authors.lastname: Spellman
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
authors.forename: Claudio
authors.initials: C
authors.lastname: Anasetti
authors.forename: William
authors.initials: W
authors.lastname: Arcese
authors.forename: Juliet N
authors.initials: JN
authors.lastname: Barker
authors.forename: Lee Ann
authors.initials: LA
authors.lastname: Baxter-Lowe
authors.forename: Maria
authors.initials: M
authors.lastname: Brown
authors.forename: Marcelo A
authors.initials: MA
authors.lastname: Fernandez-Vina
authors.forename: John
authors.initials: J
authors.lastname: Freeman
authors.forename: Wensheng
authors.initials: W
authors.lastname: He
authors.forename: Anna Paola
authors.initials: AP
authors.lastname: Iori
authors.forename: Mary M
authors.initials: MM
authors.lastname: Horowitz
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Susana
authors.initials: S
authors.lastname: Marino
authors.forename: Martin
authors.initials: M
authors.lastname: Maiers
authors.forename: Gerard
authors.initials: G
authors.lastname: Michel
authors.forename: Guillermo F
authors.initials: GF
authors.lastname: Sanz
authors.forename: Eliane
authors.initials: E
authors.lastname: Gluckman
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
mesh_terms: D000293:Adolescent; D000483:Alleles; D002648:Child; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D019337:Hematologic Neoplasms / Q000235:genetics / Q000276:immunology* / Q000628:therapy; D006648:Histocompatibility / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D008297:Male; D009504:Neutrophils / Q000166:cytology; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D006680:HLA Antigens