Limits of HLA mismatching in unrelated hematopoietic cell transplantation

DOI PDF 被引用文献5件
  • Effie W. Petersdorf
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • Claudio Anasetti
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • Paul J. Martin
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • Ted Gooley
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • Jerald Radich
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • Mari Malkki
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • Ann Woolfrey
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • Anajane Smith
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • Eric Mickelson
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  • John A. Hansen
    From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the H. Lee Moffitt Cancer Center and Research Institute; the Seattle Cancer Care Alliance; and the Department of Medicine, University of Washington School of Medicine, Seattle, WA.

抄録

<jats:title>Abstract</jats:title> <jats:p>HLA matching between the donor and recipient improves the success of unrelated hematopoietic cell transplantation (HCT). Matched donors are available for only a minority of patients. Further information is needed to evaluate the limits of HLA mismatching. We examined the association of mortality with HLA-A, -B, -C, -DRB1, and -DQB1 mismatching in 948 patients who received a T-replete unrelated HCT for treatment of a marrow disorder. A single HLA allele or antigen mismatch was associated with increased mortality among patients with chronic myeloid leukemia (CML) within 2 years after diagnosis compared to patients with no HLA mismatch, but not among those with more advanced malignancy. In particular, a single HLA-C mismatch conferred increased risk of mortality compared to matches. There was a suggestion for increased mortality with multiple mismatches involving HLA-DQB1 compared to multiple mismatches not involving HLA-DQB1. Donors with a single HLA allele or antigen mismatch may be used for HCT when a fully matched donor is not available for patients with diseases that do not permit time for a lengthy search. Whenever possible, HLA-C mismatches should be avoided for patients with early stage CML, and HLA-DQB1 mismatches should be avoided for patients with multiple mismatches.</jats:p>

収録刊行物

  • Blood

    Blood 104 (9), 2976-2980, 2004-11-01

    American Society of Hematology

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