Effect of HLA mismatching at HLA-A, -B, and -DRB1 for umbilical-cord blood transplantation in Taiwan.
Unrelated cord blood transplantation has become a reliable alternative therapy for children and adults owing to that one or two antigen/allele mismatches between a patient and the cord blood donor are acceptable without occurrence of graft-versus-host disease. To investigate the relationship between the number and types of mismatches and relapse, we compared the number of mismatched and non-mismatched donor-recipient pairs, number of mismatched alleles, and number of mismatched antigens at each of the Human Leukocyte Antigen (HLA) -A, -B, and -DR loci, respectively. The result indicates that the number of mismatched antigens at the HLA-A locus was significantly associated with occurrence of relapse (X2P-value=0.0243; RR=1.49, 95% CI: 1.04-2.13). Additionally, the number of mismatched donor-recipient pairs and the number of mismatched alleles at the HLA-DR locus was negatively associated with risks of relapse (X2P-value=0.0028; RR=0.52, 95% CI: 0.31-0.89). In this study, we found that the mismatch at the HLA-A locus is associated with increased risk of relapse; while the mismatch at the HLA-DR locus is innocuous. Hence, we suggest that the well-matched HLA-A alleles were most critical for matching HLA alleles between umbilical-cord blood transplantation donors and recipients. In other words, cord blood transplantation requires less stringent HLA matching, if there are two 5/6 or 4/6 HLA matched donors, it's better to choose HLA-A matched donor at least.
Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan County, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan County, Taiwan. Electronic address: a12048@adm.cgmh.org.tw.
Ding-Ping
DP
Chen
Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Su-Wei
SW
Chang
Department of Pediatrics, Division of Hematology/Oncology, Chang Gung Children's Hospital, Chang Gung University, Taoyuan County, Taiwan.
Tang-Her
TH
Jaing
Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan County, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan County, Taiwan.
Ching-Ping
CP
Tseng
Department of Pediatrics, Division of Hematology/Oncology, Chang Gung Children's Hospital, Chang Gung University, Taoyuan County, Taiwan.
Shih-Hsiang
SH
Chen
Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan County, Taiwan.
Wei-Ting
WT
Wang
D000483:Alleles; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D006086:Graft vs Host Disease / Q000235:genetics* / Q000276:immunology; D015234:HLA-A Antigens / Q000235:genetics*; D015235:HLA-B Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains / Q000235:genetics*; D006801:Humans; D012008:Recurrence; D013624:Taiwan
D015234:HLA-A Antigens; D015235:HLA-B Antigens; D059811:HLA-DRB1 Chains
Cord blood transplantation; Graft-versus-host disease; Human Leukocyte Antigen