title: Donor-recipient allele-level HLA matching of unrelated cord blood units reveals high degrees of mismatch and alters graft selection.
abstract: The feasibility of selecting cord blood (CB) units at high-resolution HLA match has not been investigated. We analyzed the high-resolution donor-recipient HLA match of 100 double-unit 4-6/6 HLA-A,-B antigen, -DRB1 allele-matched CB grafts (units 1a and 1b) and their back-up units (n=377 units in total). The median cryopreserved graft dose was 2.9 × 10(7)/kg/unit, and at high resolution these units had a median donor-recipient HLA-allele match of 5/8 (range 2-8/8) and 6/10 (range 2-9/10), respectively. We then evaluated how often use of high-resolution HLA-match criteria would change the original graft selection to substitute one or both of the back-up units for units 1a and/or 1b. On using a model in which both a higher eight-allele HLA match and a cell dose ⩾ 2.0 × 10(7)/kg/unit were required, graft selection changed in 33% of transplants with minimal effect on cell dose (8.3% reduction). In summary, while units chosen based on HLA-A,-B antigen and -DRB1 allele match have substantial mismatch at higher resolution, CB selection based on high-resolution HLA match is possible in a significant proportion of patients without compromise in cell dose.
authors.affiliation: 1] Adult Bone Marrow Transplantation Service, Department of Medicine, New York, NY, USA [2] Weill Cornell Medical College, New York, NY, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: Dahi
authors.affiliation: 1] Adult Bone Marrow Transplantation Service, Department of Medicine, New York, NY, USA [2] Weill Cornell Medical College, New York, NY, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Ponce
authors.affiliation: Department of Biostatistics, New York, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Devlin
authors.affiliation: Adult Bone Marrow Transplantation Service, Department of Medicine, New York, NY, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Evans
authors.affiliation: Adult Bone Marrow Transplantation Service, Department of Medicine, New York, NY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Lubin
authors.affiliation: Adult Bone Marrow Transplantation Service, Department of Medicine, New York, NY, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Gonzales
authors.affiliation: Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: C
authors.initials: C
authors.lastname: Byam
authors.affiliation: Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Sideroff
authors.affiliation: Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Wells
authors.affiliation: 1] Adult Bone Marrow Transplantation Service, Department of Medicine, New York, NY, USA [2] Weill Cornell Medical College, New York, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Giralt
authors.affiliation: Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Kernan
authors.affiliation: Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Scaradavou
authors.affiliation: 1] Adult Bone Marrow Transplantation Service, Department of Medicine, New York, NY, USA [2] Weill Cornell Medical College, New York, NY, USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D005312:Fetal Blood / Q000276:immunology*; D015235:HLA-B Antigens / Q000235:genetics* / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D015235:HLA-B Antigens