title: Comparable outcome after single-antigen-mismatched versus matched unrelated donor haematopoietic cell transplantation.
abstract: OBJECTIVE
  Allogeneic haematopoietic stem cell transplantation (HSCT) is a proven treatment for patients with haematological malignancies. In this retrospective analysis, the impact of donor matching on outcome of unrelated HSCT was analysed in patients transplanted at the University of Leipzig.
  
  
  METHODS
  From 2000 to 2009, 206 patients were transplanted from unrelated donors, of which 51 were mismatched (39 in 1 and 12 in ≥ 2 HLA-antigens), using peripheral blood or bone marrow grafts after total body irradiation and cyclophosphamide or busulfan and cyclophosphamide preparative regimens in combination with ATG. For graft-versus-host disease (GvHD) prophylaxis cyclosporine and MTX were administered.
  
  
  RESULTS
  After a median follow-up of 49 months, outcome at 5 years in recipients of HLA-identical grafts was comparable to that of patients transplanted from HLA-incompatible donors with an overall survival (OS) of 52 % (95 % CI 43-61) versus 48 % (95 % CI 34-63), respectively (p = 0.48). Results were also comparable for event-free survival at 5 years [47 % (95 % CI 38-56) vs. 39 % (95 % CI 25-54); p = 0.44], relapse incidence (RI) [29 % (95 % CI 20-38) vs. 41 (95 % CI 25-57); p = 0.22] and non-relapse mortality [24 % (95 % CI 16-33) vs. 20 % (95 % CI 8-33); p = 0.84] in the matched versus mismatched groups. Incidence of acute and chronic GvHD was similar in both groups. Advanced disease (p = 0.02) and low-resolution typing (p = 0.04) are risk factors for OS and RI in univariate and multivariate analysis.
  
  
  CONCLUSIONS
  Donors with one antigen mismatch are an acceptable option for patients with malignant disease for whom no fully matched donor is available.
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Rockstroh
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany.
authors.forename: H K
authors.initials: HK
authors.lastname: Al-Ali
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Lange
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Pönisch
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Krahl
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Cross
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Behre
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Niederwieser
authors.affiliation: Department of Hematology and Medical Oncology, University Hospital Leipzig, 04103, Leipzig, Germany. christian.pfrepper@ediacon.de.
authors.forename: C
authors.initials: C
authors.lastname: Pfrepper
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000276:immunology / Q000401:mortality*; D006680:HLA Antigens / Q000276:immunology; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006648:Histocompatibility; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000401:mortality* / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D006680:HLA Antigens
keywords: Allogeneic stem cell transplantation; Graft-versus-host disease; HLA-antigen mismatch; Relapse; Unrelated donors