title: HLA disparity is not crucial for the survival rate and severity of chronic health conditions in adult recipients following family donor hematopoietic stem cell transplantation.
abstract: The shortage of HLA-identical siblings or unrelated donors has restricted the application of hematopoietic stem cell transplantation (HSCT). Few studies have systematically assessed survival and chronic health conditions (CHCs) in the same cohort of patients after HLA-mismatched/haploidentical (mismatched) family donor transplantation. In the present study, we retrospectively analyzed the survival of 127 adult patients receiving either HLA-matched (71 cases) or HLA-mismatched (56 cases) family donor transplantation. Of 127 patients, 81 patients survived at least 2 years after HSCT and were still alive until the present investigation. We evaluated the CHCs in 76 survivors (41 matched and 35 mismatched). CHC-related information was scored according to the Bone Marrow Transplant Survivor Study questionnaire. There was no significant difference in overall survival or disease-free survival between HLA-matched and -mismatched transplant recipients. The CHCs were less severe in HLA-mismatched recipients than in matched cohorts. Multivariate analysis identified that age over 40 years at transplantation and presence of chronic graft-versus-host disease were independent risk factors for CHCs, while anti-thymocyte globulin-containing conditioning regimens might be protective. However, HLA disparity was not crucial for either the survival rate or CHCs. In conclusion, HLA-mismatched family donor transplantation can achieve comparable therapeutic effects to HLA-identical sibling transplantation.
authors.affiliation: Department of Hematology, Peking University First Hospital, #8, Xishihu Street, Beijing, 100034, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Wang
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Dong
authors.forename: Zhi-Xiang
authors.initials: ZX
authors.lastname: Qiu
authors.forename: Mang-Ju
authors.initials: MJ
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Wang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Sun
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Xu
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Ou
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Wang
authors.forename: Ze-Yin
authors.initials: ZY
authors.lastname: Liang
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
authors.forename: Xi-Nan
authors.initials: XN
authors.lastname: Cen
authors.forename: Han-Yun
authors.initials: HY
authors.lastname: Ren
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D035781:Siblings; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data; D066027:Transplant Recipients / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D006680:HLA Antigens