The impact of HLA-A,HLA-B,HLA-DRB1 high-resolution matching on the prognosis of hematopoietic stem cell transplantation from unrelated donors:a retrospective report
10.3760/cma.j.issn.1009-9921.2013.10.005
- VernacularTitle:非血缘造血干细胞移植中HLA-A、HLA-B、HLA-DRB1高分辨位点匹配程度与预后的相关性分析
- Author:
Xing FAN
;
Ling WANG
;
Wei TANG
;
Jiong HU
- Publication Type:Journal Article
- Keywords:
Hematopoietic stem cell transplantation;
Unrelated donors;
HLA matching;
Survival analysis;
Graft vs host disease
- From:
Journal of Leukemia & Lymphoma
2013;22(10):589-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the impact of HLA-A,HLA-B,HLA-DRB1 matching on the prognosis of hematopoietic stem cell transplantation from unrelated donors.Methods A total of 81 patients with hematological malignancies including leukemia,myelodysplastic syndrome(MDS)and lymphoma who underwent hematopoietic stem cell transplantation from unrelated donors from 2007 to 2012 in our department were included in this retrospective analysis.Patients were classified into HLA match group(n=53)and HLA mismatch group(n=28)according to the HLA high-resolution matching.The overall survival (OS),treatmentrelated mortality(TRM),relapse rate(RR),graft-versus-host disease(GVHD)incidence were analyzed.Results The 81 patients were analyzed with a median follow-up of 11.9 months(0.3 to 57.4 months).The OS (66.0％vs 46.4％,P=0.031)and TRM(17.0％vs 42.9％,P=0.017)were significantly different between the HLA match group and HLA mismatch group,while the RR had no significant difference(14.3％vs 32.1％,P=0.111).Multivariate analysis showed HLA matching was an independent prognostic factor of TRM,but not OS.There's no significant difference of aGVHD(22.9％vs 40.9％,P=0.122)and cGVHD (40.0％vs 46.7％,P=0.655)incidence between the two groups,but the incidence of severe aGVHD in HLA match group were much lower(4.2％vs 25.0％,P=0.005)than HLA mismatch group.Conclusion the high-resolution matching of HLA-A,-B,DRB1 affect OS,TRM and the incidence of severe aGVHD in unrelated hematopoietic stem cell transplantation,but not affect RR,the incidence of aGVHD and cGVHD.
