High resolution HLA matching associated with decreased mortality after unrelated bone marrow transplantation
Details
Serval ID
serval:BIB_B7F6B55FFAC5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
High resolution HLA matching associated with decreased mortality after unrelated bone marrow transplantation
Journal
Blood
ISSN
0006-4971 (Print)
Publication state
Published
Issued date
05/1996
Volume
87
Number
10
Pages
4455-62
Notes
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: May 15
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: May 15
Abstract
As compared with related HLA-identical sibling donors, bone marrow transplantation (BMT) with phenotypically HLA ABDR-compatible unrelated donors is associated with increased mortality. This may be due to hidden HLA incompatibilities not detected by conventional typing. We have analyzed 44 unrelated patient-donor pairs who were matched for HLA-A, -B, and -DR by routine tissue typing. Our comprehensive HLA typing approach consisted of serology, cytotoxic T-cell precursor (CTLp) tests, T-cell cloning, oligotyping, and DNA sequencing. Using these techniques, we identified numerous HLA allele mismatches not detected by the previously applied routine typing. Twenty-four patient-donor pairs were highly matched and had a low CTLp frequency, whereas the remaining 20 pairs were allele-mismatched for HLA-A, -B, -C, -DR, -DQ antigens and/or had a positive result of the CTLp test. Patient and donor age, diagnosis, and treatment did not differ significantly between the matched and mismatched transplants. The probability for severe acute graft-versus-host disease grades III-IV was 21% in the matched and 47% in the mismatched patients (P = .0464). Transplant-related mortality was 21% and 57% (P = .0072) and actuarial patient survival rates at 3 years were 61% and 13% (P = .0005). We conclude that both HLA class I and class II allele mismatches between unrelated phenotypically ABDR-compatible patient-donor pairs are frequent and associated with increased incidence of posttransplant complications.
Keywords
Alleles
Bone Marrow Transplantation/immunology/*mortality
Cause of Death
Female
Follow-Up Studies
Graft vs Host Disease/immunology/mortality/prevention & control
HLA Antigens/analysis/immunology
Histocompatibility Testing/*methods
Humans
Infection/etiology/mortality
Life Tables
Male
Survival Analysis
Survival Rate
Transplantation, Homologous/immunology/mortality
Pubmed
Web of science
Create date
28/01/2008 12:33
Last modification date
20/08/2019 16:26