Impact of a single human leucocyte antigen (HLA) allele mismatch on the outcome of unrelated bone marrow transplantation over two time periods. A retrospective analysis of 3003 patients from the HLA Working Group of the Japan Society for Blood and Marrow Transplantation

Yoshinobu Kanda, Junya Kanda, Yoshiko Atsuta, Yoshinobu Maeda, Tatsuo Ichinohe, Kazuteru Ohashi, Takahiro Fukuda, Koichi Miyamura, Hiroatsu Iida, Takehiko Mori, Koji Iwato, Tetsuya Eto, Keisei Kawa, Satoshi Morita, Yasuo Morishima

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Abstract

A previous Japanese study revealed that a human leucocyte antigen (HLA)-A or -B allele mismatch was associated with higher overall mortality, whereas an HLA-C or -DRB1 allele mismatch did not affect mortality after serologically matched unrelated bone marrow transplantation (BMT). This study reanalysed 3003 adult patients who underwent unrelated BMT from a serologically HLA-A, -B, or -DR matched unrelated donor between 1993 and 2009 using the latest database, that included 1966 HLA-matched unrelated BMT and 187, 31, 524, and 295 unrelated BMT with a single HLA-A, -B, -C, or -DRB1 allele mismatch, respectively. As opposed to our previous findings, HLA-C and -DRB1 mismatches had a significant negative impact [hazard ratio (HR) 1·35, P<0·001, and HR 1·45, P<0·001] on survival in the period 2000-2009. The negative impact of each single HLA allele mismatch was not significantly different among the HLA-A, -B, -C, and -DRB1 mismatches (P=0·79). An interaction test revealed that the effects of single HLA-C and -DRB1 allele mismatches significantly differed over the two time periods (P=0·032 and P=0·0072, respectively). In conclusion, the impact of a single HLA allele mismatch changed over time. In the recent cohort, the negative impact of HLA-DRB1 and -C mismatches became apparent.

Original languageEnglish
Pages (from-to)566-577
Number of pages12
JournalBritish Journal of Haematology
Volume161
Issue number4
DOIs
Publication statusPublished - 2013 May 1

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Keywords

  • Allogeneic haematopoietic stem cell transplantation
  • Graft-versus-host disease
  • Human leucocyte antigen
  • Human leucocyte antigen mismatch
  • Unrelated donor

ASJC Scopus subject areas

  • Hematology

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