TY - JOUR
T1 - Short-term clinical outcomes after HLA 1-locus mismatched uPBSCT are similar to that after HLA-matched uPBSCT and uBMT
AU - the HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation
AU - Fuji, Shigeo
AU - Miyamura, Koichi
AU - Kanda, Yoshinobu
AU - Fukuda, Takahiro
AU - Kobayashi, Takeshi
AU - Ozawa, Yukiyasu
AU - Iwato, Koji
AU - Uchida, Naoyuki
AU - Eto, Tetsuya
AU - Ashida, Takashi
AU - Mori, Takehiko
AU - Sawa, Masashi
AU - Ichinohe, Tatsuo
AU - Atsuta, Yoshiko
AU - Kanda, Junya
N1 - Publisher Copyright:
© 2019, Japanese Society of Hematology.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - In Japan, use of unrelated peripheral blood stem cell transplantation (uPBSCT) from HLA-mismatched unrelated donors has recently been approved. We compared outcomes between HLA-matched and 1-locus mismatched uPBSCT, as well as the impact of HLA disparity in uPBSCT and in unrelated bone marrow transplantation (uBMT). In total, 5862 uBMT recipients and 234 uPBSCT recipients were included. In terms of HLA allele disparity, 185 uPBSCT patients (79.1%) had no HLA mismatch, and 49 (20.9%) had 1-locus mismatch; in comparison, 3585 uBMT patients (61.2%) had no HLA mismatch, and 2277 (38.8%) had 1-locus mismatch. The impact of 1-locus mismatch as compared with match in uPBSCT was not significantly higher than in uBMT [hazard ratio (HR) = 1.02 and 1.27 for grade III–IV acute graft-versus-host disease, HR = 0.98 and 1.14 for non-relapse mortality, and HR = 0.87 and 1.06 for overall survival, respectively]. In conclusion, the impact of single-locus mismatch on short-term outcomes was comparable in uPBSCT and uBMT. Larger studies with longer follow-up are needed to assess long-term outcomes.
AB - In Japan, use of unrelated peripheral blood stem cell transplantation (uPBSCT) from HLA-mismatched unrelated donors has recently been approved. We compared outcomes between HLA-matched and 1-locus mismatched uPBSCT, as well as the impact of HLA disparity in uPBSCT and in unrelated bone marrow transplantation (uBMT). In total, 5862 uBMT recipients and 234 uPBSCT recipients were included. In terms of HLA allele disparity, 185 uPBSCT patients (79.1%) had no HLA mismatch, and 49 (20.9%) had 1-locus mismatch; in comparison, 3585 uBMT patients (61.2%) had no HLA mismatch, and 2277 (38.8%) had 1-locus mismatch. The impact of 1-locus mismatch as compared with match in uPBSCT was not significantly higher than in uBMT [hazard ratio (HR) = 1.02 and 1.27 for grade III–IV acute graft-versus-host disease, HR = 0.98 and 1.14 for non-relapse mortality, and HR = 0.87 and 1.06 for overall survival, respectively]. In conclusion, the impact of single-locus mismatch on short-term outcomes was comparable in uPBSCT and uBMT. Larger studies with longer follow-up are needed to assess long-term outcomes.
KW - Anti-thymocyte globulin
KW - HLA disparity
KW - Peripheral blood stem cell transplantation
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U2 - 10.1007/s12185-019-02631-z
DO - 10.1007/s12185-019-02631-z
M3 - Article
C2 - 30877606
AN - SCOPUS:85063061636
SN - 0925-5710
JO - International Journal of Hematology
JF - International Journal of Hematology
ER -