title: A single high-resolution HLA mismatch has a similar adverse impact on the outcome of related hematopoietic stem cell transplantation as a single low-resolution HLA mismatch.
abstract: The relative importance of the resolution level of HLA typing has not been fully defined for related donor transplantation. To address this question, we retrospectively evaluated patients who underwent a first related hematopoietic stem cell transplantation (HSCT) from 2000 to 2011 from an HLA high-resolution matched (MRD, n = 2,244), high-resolution 1 locus-mismatched (HR-MMRD, n = 116), or low-resolution 1 locus-mismatched related donor (LR-MMRD, n = 396) in the graft-versus-host direction at three loci (HLA A, B, and DRB1) using the database of the Japan Society for Hematopoietic Cell Transplantation. The median age was 40 years (0-74). The median follow-up duration of surviving patients was 950 days. Although the cumulative incidences of grade III-IV acute graft-versus-host disease (GVHD) in the HR-MMRD and LR-MMRD groups were significantly higher than those in the MRD group (HR-MMRD 19.8%, LR-MMRD 20.4%, and MRD 9.5%), there was no statistically significant difference between the HR-MMRD and LR-MMRD groups (P = 0.65). Although both HR-MMRD and LR-MMRD were significantly associated with an increased risk of non-relapse mortality and a worse overall survival, there was no statistically significant difference between the HR-MMRD and LR-MMRD groups. In conclusion, LR-MM and HR-MM have a similar adverse impact on the outcome in related HSCT.
authors: Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Shigeo
authors: S
authors: Fuji
authors: Division of Hematology, Saitama Medical Center, Saitama, Japan.
authors: Junya
authors: J
authors: Kanda
authors: Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan.
authors: Shunichi
authors: S
authors: Kato
authors: Division of Hematology, Department of Internal Medicine, Hyogo Medical College, Hyogo, Japan.
authors: Kazuhiro
authors: K
authors: Ikegame
authors: Department of Hematology, Fujita Health University School of Medicine, Nagoya, Japan.
authors: Satoko
authors: S
authors: Morishima
authors: Medicine and Biosystemic Science, Kyushu University Hospital, Fukuoka, Japan.
authors: Toshihiro
authors: T
authors: Miyamoto
authors: Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.
authors: Michihiro
authors: M
authors: Hidaka
authors: Department of Hematology, Aomori Prefectural Central Hospital, Aomori, Japan.
authors: Kohmei
authors: K
authors: Kubo
authors: Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors: Koichi
authors: K
authors: Miyamura
authors: Department of Hematology, Osaka Red Cross Hospital, Osaka, Japan.
authors: Mitsuru
authors: M
authors: Tsudo
authors: Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan.
authors: Hikaru
authors: H
authors: Kobayashi
authors: Department of Hematology, Tenri Hospital, Nara, Japan.
authors: Yoshitomo
authors: Y
authors: Maesako
authors: Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
authors: Tetsuya
authors: T
authors: Eto
authors: Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Souichi
authors: S
authors: Adachi
authors: Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
authors: Tatsuo
authors: T
authors: Ichinohe
authors: Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.|Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
authors: Yoshiko
authors: Y
authors: Atsuta
authors: Division of Hematology, Saitama Medical Center, Saitama, Japan.
authors: Yoshinobu
authors: Y
authors: Kanda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D030562:Databases, Protein; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality* / Q000473:pathology*; D006680:HLA Antigens / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000401:mortality*; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016019:Survival Analysis; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D006680:HLA Antigens