TY - JOUR
T1 - Matching at Human Leukocyte Antigen-C Improved the Outcomes after Double Umbilical Cord Blood Transplantation for Recipients of Two to Four of Six Human Leukocyte Antigen–Matched Grafts
AU - Brunstein, Claudio G.
AU - Cutler, Corey S.
AU - DeFor, Todd E.
AU - Kim, Haesook
AU - Bejanyan, Nelli
AU - Garfall, Alfred
AU - Verneris, Michael R.
AU - Chen, Yi Bin
AU - Warlick, Erica D.
AU - Spitzer, Thomas
AU - Miller, Jeffrey S.
AU - Antin, Joseph H.
AU - Weisdorf, Daniel J.
AU - Soiffer, Robert
AU - Wagner, John E.
AU - Ballen, Karen K.
N1 - Publisher Copyright:
© 2017
PY - 2017/1/1
Y1 - 2017/1/1
N2 - We studied the effect of HLA-C matching in 515 patients after double umbilical cord blood (UCB) transplantation. After HLA matching HLA-A, -B, and -DRB1 at the allele level, we scored patients according to number of donor-recipient HLA-C matches at 4 possible loci: 2 from each donor unit, at the allele level. Given a direct interaction between HLA-A, -B, and -DRB1 matching and HLA-C score, we analyzed HLA-C matching in those receiving at least 1 2/6 to 4/6 HLA–matched unit (n = 389) versus those receiving only 5/6 or 6/6–matched units (n = 126). In those with at least 1 2/6 to 4/6 HLA–matched unit, a better HLA-C matching score was associated with significantly lower risk of death of any cause and nonrelapse mortality and better disease-free survival. There was no association with the risk of relapse, acute and chronic graft-versus-host disease, and hematopoietic recovery. In contrast, among patients receiving only allele-level 5/6 or 6/6 HLA–matched UCB units, HLA-C match had no demonstrable effect on any outcome. For patients receiving at least 1 allele-level 2/6 to 4/6 HLA–matched UCB unit, matching at HLA-C reduces nonrelapse mortality and improves survival.
AB - We studied the effect of HLA-C matching in 515 patients after double umbilical cord blood (UCB) transplantation. After HLA matching HLA-A, -B, and -DRB1 at the allele level, we scored patients according to number of donor-recipient HLA-C matches at 4 possible loci: 2 from each donor unit, at the allele level. Given a direct interaction between HLA-A, -B, and -DRB1 matching and HLA-C score, we analyzed HLA-C matching in those receiving at least 1 2/6 to 4/6 HLA–matched unit (n = 389) versus those receiving only 5/6 or 6/6–matched units (n = 126). In those with at least 1 2/6 to 4/6 HLA–matched unit, a better HLA-C matching score was associated with significantly lower risk of death of any cause and nonrelapse mortality and better disease-free survival. There was no association with the risk of relapse, acute and chronic graft-versus-host disease, and hematopoietic recovery. In contrast, among patients receiving only allele-level 5/6 or 6/6 HLA–matched UCB units, HLA-C match had no demonstrable effect on any outcome. For patients receiving at least 1 allele-level 2/6 to 4/6 HLA–matched UCB unit, matching at HLA-C reduces nonrelapse mortality and improves survival.
KW - Alternative donor transplantation
KW - Double umbilical cord blood
KW - Human leukocyte antigen
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U2 - 10.1016/j.bbmt.2016.10.018
DO - 10.1016/j.bbmt.2016.10.018
M3 - Article
C2 - 27989929
AN - SCOPUS:85006337114
SN - 1083-8791
VL - 23
SP - 126
EP - 133
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 1
ER -