Outcomes of peripheral blood stem cell transplantation in patients from human leukocyte antigen matched or mismatched unrelated donors.

Tingting Cao; Yanfen LI; Quanshun Wang; Honghua LI; Jian BO; Yu Zhao; Yu Jing; Shuhong Wang; Haiyan Zhu; Liping Dou; Bojun Jia; Chunji Gao; Li YU; Wenrong Huang

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Outcomes of peripheral blood stem cell transplantation in patients from human leukocyte antigen matched or mismatched unrelated donors.

Author: Tingting CAO ^{1
,

2} ; Yanfen LI ³ ; Quanshun WANG ³ ; Honghua LI ³ ; Jian BO ³ ; Yu ZHAO ³ ; Yu JING ³ ; Shuhong WANG ³ ; Haiyan ZHU ³ ; Liping DOU ³ ; Bojun JIA ³ ; Chunji GAO ³ ; Li YU ³ ; Wenrong HUANG ¹ ;
Author Information

1. Department of Hematology, Chinese People's Liberation Army General Hospital, Beijing 100853, China
2. Department of Hematology, Cangzhou Central Hospital, Cangzhou, Hebei 061001, China.
3. Department of Hematology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Publication Type:Journal Article
MeSH: Adolescent; Adult; Child; Female; HLA Antigens; immunology; Humans; Male; Middle Aged; Peripheral Blood Stem Cell Transplantation; standards; Unrelated Donors; Young Adult
From: Chinese Medical Journal 2014;127(14):2612-2617
CountryChina
Language:English
Abstract:
BACKGROUNDAllogeneic peripheral blood stem cell transplantation from unrelated donors (UR-PBSCT) is an alternative treatment for many hematologic diseases due to lack of human leukocyte antigen (HLA)-identical sibling donors. This study aimed to evaluate the impact of the degree of the HLA match on the clinical efficacy of UR-PBSCT.
METHODSPatients who underwent UR-PBSCT from September 2003 to September 2012 were retrospectively investigated. They were divided into three groups according to high-resolution molecular typing. SPSS version 17.0 was used to analysis and compare the statistics of engraftment, incidence of GVHD, other complications and survival among the groups.
RESULTSOne hundred and eleven patients received UR-PBSCT, 60 of them with an HLA matched donor (10/10), 36 of them with a one locus mismatched donor (9/10), and 15 of them with a two loci mismatched donor (8/10). Similar basic characteristics were found in the three groups. No differences were found in engraftment of myeloid cells or platelets in the three groups (P > 0.05). Two-year cumulative incidence of relapse, overall survival (OS) and disease-free survival (DFS) among those three groups were similar (P > 0.05). The cumulative incidence of 100-day III-IV aGVHD in the HLA matched group and the one HLA locus mismatched group were significantly lower than that in the two HLA loci mismatched group (3.3%, 8.6%, and 26.7%, P = 0.009). The occurrence rate of new pulmonary infections in the HLA matched group was lower than in the two HLA mismatched groups (26.67%, 52.78%, and 41.18%, P = 0.035). The cumulative incidence of 100-day and 2-year transplantation related mortality (TRM) in two HLA loci mismatched group was higher than in the HLA matched group and in the one HLA locus mismatched group, (8.4%, 11.8% and 33.3%, P = 0.016) and (12.3%, 18.7% and 47.5%, P = 0.002).
CONCLUSIONSHLA mismatch will not significantly impact the engraftment or 2-year survival after UR-PBSCT, but two mismatched HLA loci may increase the cumulative incidence of severe aGVHD and TRM.