The Impact of HLA Matching on Unrelated Donor Hematopoietic Stem Cell Transplantation in Korean Children

Overview

Journal Korean J Hematol

Specialty Hematology

Date 2011 Apr 5

PMID 21461298

Citations 3

Authors

Meerim Park

Kyung Nam Koh

Bo Eun Kim

Ho Joon Im

Kyung Duk Park

Hyoung Jin Kang

Hee Young Shin

Hyo Seop Ahn

Keon Hee Yoo

Ki Woong Sung

Hong Hoe Koo

Hyeon Jin Park

Byung-Kiu Park

Jong Jin Seo

Affiliations

Soon will be listed here.

Abstract

Background: The impact of HLA matching on outcomes of unrelated donor (URD) hematopoietic stem cell transplantation (HSCT) varies in different racial or ethnic groups. Since little is known about the impact of such matching on URD HSCT in Korean children, we analyzed this issue.

Methods: We analyzed the outcomes of 142 patients who underwent URD HSCT at 4 Korean medical centers. All patient donor pairs were fully typed for HLA-A, -B, -C, and -DR alleles.

Results: At a median follow-up of 22 months, 3-year survival rates for patients with 8, 7, and ≤6 matched alleles were 88.4%, 70.7%, and 53.6%, respectively. A single mismatch (Mm) at HLA-B or -C was associated with lower survival compared with that associated with 8 matched alleles. No significant differences were observed between single-allele and single-antigen Mms with respect to survival rate or acute graft-versus-host disease (aGVHD) incidence rates. HLA disparity had a greater impact on the survival of patients with high-risk malignancy than of those with low-risk malignancy. Among pairs with a single Mm, only locus A showed a significant association and higher risk of grade III-IV aGVHD compared to those in patients with 8 matched alleles.

Conclusion: Disparity in HLA class I, regardless of antigen or allele Mm, adversely affected both survival and grade III-IV aGVHD development. An increased number of HLA Mms was associated with a higher risk of post-transplantation complications. Further investigations using larger cohorts are required to confirm the effects of HLA mismatching on URD HSCT patient outcomes.

Citing Articles

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Clinical implications of HLA locus mismatching in unrelated donor hematopoietic cell transplantation: a meta-analysis.

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Shedding a new light on the HLA matching.

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