» Articles » PMID: 27989929

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

Abstract

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.

Citing Articles

Role of Stem-Cell Transplantation in Leukemia Treatment.

Dessie G, Molla M, Shibabaw T, Ayelign B Stem Cells Cloning. 2020; 13:67-77.

PMID: 32982314 PMC: 7493021. DOI: 10.2147/SCCAA.S262880.


Composite GRFS and CRFS Outcomes After Adult Alternative Donor HCT.

Mehta R, Holtan S, Wang T, Hemmer M, Spellman S, Arora M J Clin Oncol. 2020; 38(18):2062-2076.

PMID: 32364845 PMC: 7302955. DOI: 10.1200/JCO.19.00396.


Human Leukocyte Antigen and Red Blood Cells Impact Umbilical Cord Blood CD34 Cell Viability after Thawing.

Vanegas D, Galindo C, Paez-Gutierrez I, Gonzalez-Acero L, Medina-Valderrama P, Lozano J Int J Mol Sci. 2019; 20(19).

PMID: 31575081 PMC: 6801469. DOI: 10.3390/ijms20194875.


Selection of unrelated donors and cord blood units for hematopoietic cell transplantation: guidelines from the NMDP/CIBMTR.

Dehn J, Spellman S, Hurley C, Shaw B, Barker J, Burns L Blood. 2019; 134(12):924-934.

PMID: 31292117 PMC: 6753623. DOI: 10.1182/blood.2019001212.


Patients Lacking a KIR-Ligand of HLA Group C1 or C2 Have a Better Outcome after Umbilical Cord Blood Transplantation.

Martinez-Losada C, Martin C, Gonzalez R, Manzanares B, Garcia-Torres E, Herrera C Front Immunol. 2017; 8:810.

PMID: 28751893 PMC: 5507950. DOI: 10.3389/fimmu.2017.00810.

References
1.
Lee S, Klein J, Haagenson M, Baxter-Lowe L, Confer D, Eapen M . High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation. Blood. 2007; 110(13):4576-83. DOI: 10.1182/blood-2007-06-097386. View

2.
Brunstein C, Wagner J, Weisdorf D, Cooley S, Noreen H, Barker J . Negative effect of KIR alloreactivity in recipients of umbilical cord blood transplant depends on transplantation conditioning intensity. Blood. 2009; 113(22):5628-34. PMC: 2689057. DOI: 10.1182/blood-2008-12-197467. View

3.
Eapen M, Klein J, Sanz G, Spellman S, Ruggeri A, Anasetti C . Effect of donor-recipient HLA matching at HLA A, B, C, and DRB1 on outcomes after umbilical-cord blood transplantation for leukaemia and myelodysplastic syndrome: a retrospective analysis. Lancet Oncol. 2011; 12(13):1214-21. PMC: 3245836. DOI: 10.1016/S1470-2045(11)70260-1. View

4.
Cutler C, Kim H, Sun L, Sese D, Glotzbecker B, Armand P . Donor-specific anti-HLA antibodies predict outcome in double umbilical cord blood transplantation. Blood. 2011; 118(25):6691-7. PMC: 3976219. DOI: 10.1182/blood-2011-05-355263. View

5.
Willemze R, Rodrigues C, Labopin M, Sanz G, Michel G, Socie G . KIR-ligand incompatibility in the graft-versus-host direction improves outcomes after umbilical cord blood transplantation for acute leukemia. Leukemia. 2009; 23(3):492-500. PMC: 7101531. DOI: 10.1038/leu.2008.365. View