title: Impact of HLA allele mismatch on the clinical outcome in serologically matched related hematopoietic SCT.
abstract: In unrelated hematopoietic SCT (HSCT), HLA allele mismatch has been shown to have a significant role. To clarify the importance of HLA allele mismatch in the GVH direction in related HSCT, we retrospectively evaluated 2377 patients who received stem cells from an HLA serologically matched related donor in the GVH direction using the database of the Japan Society for Hematopoietic Cell Transplantation. The cumulative incidences of grade II-IV and grade III-IV acute GVHD in patients with an HLA allele-mismatched donor (n=133, 5.6%) were significantly higher than those in patients with an HLA allele-matched donor. Multivariate analyses showed that the presence of HLA allele mismatch was associated with increased risks of grade II-IV and grade III-IV acute GVHD. In particular, HLA-B mismatch and multiple allele mismatches were associated with an increased risk of acute GVHD. The presence of HLA allele mismatch was associated with an inferior OS owing to an increased risk of non-relapse mortality (NRM). In conclusion, the presence of HLA allele mismatch in the GVH direction in related HSCT was associated with increased risks of GVHD and NRM, which led to an inferior OS. HLA allele typing is recommended in related HSCT.
authors.affiliation: Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Fuji
authors.affiliation: Division of Hematology, Saitama Medical Center, Saitama, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Kanda
authors.affiliation: Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kato
authors.affiliation: Division of Hematology, Department of Internal Medicine, Hyogo Medical College, Hyogo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ikegame
authors.affiliation: Department of Hematology, Fujita Health University School of Medicine, Nagoya, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Morishima
authors.affiliation: Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hidaka
authors.affiliation: Department of Hematology, Aomori Prefectural Central Hospital, Aomori, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kubo
authors.affiliation: Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Miyamura
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ohashi
authors.affiliation: Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Hematology, Tenri Hospital, Nara, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Maesako
authors.affiliation: Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Adachi
authors.affiliation: Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ichinohe
authors.affiliation: Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Atsuta
authors.affiliation: Division of Hematology, Saitama Medical Center, Saitama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006648:Histocompatibility / Q000235:genetics / Q000276:immunology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D006680:HLA Antigens