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The effect of HLA disparity on clinical outcome after HLA-haploidentical blood and marrow transplantation

Authors


  • Conflict of interest: The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Corresponding author: Xiao-Jun Huang, MD, Professor, Peking University Institute of Hematology, Peking University People’s Hospital, No. 11 Xizhimen South Street, Beijing 100044, China.
Tel.: +86 010 88326006; fax: +86 010 88324577; e-mail: xjhrm@medmail.com.cn

Abstract

Huo M-R, Xu L-P, Li D, Liu D-H, Liu K-Y, Chen H, Han W, Chen Y-H, Wang Y, Wang J-Z, Zhang X-H, Zhao X-Y, Huang X-J. The effect of HLA disparity on clinical outcome after HLA-haploidentical blood and marrow transplantation.
Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01499.x.
© 2011 John Wiley & Sons A/S.

Abstract:  The relative importance of various human leukocyte antigen (HLA) loci has not been established for unmanipulated HLA-mismatched/haploidentical transplantation. To address this question, we analyzed the impact of HLA-A, HLA-B, HLA-DRB1, HLA-DRB3, HLA-DRB4, and HLA-DRB5 on the outcome of HLA-haploidentical transplantation. Four hundred and eighty-one donor–recipient pairs were fully typed before transplantation. In univariate analysis, HLA-B mismatch not only demonstrated significant adverse effects on acute graft-versus-host disease (GVHD) and transplant-related mortality but also was associated with reduced overall survival and leukemia-free survival (LFS). In multivariate analysis, HLA-B mismatch remained the independent risk factor for acute GVHD and transplant-related mortality. The high risk of disease and the female donor were found to be significant factors for reduced overall survival and LFS. Furthermore, multiple mismatch of the HLA locus was found to have no synergistic adverse effect on outcomes. Our results suggest that prospective matching of patients and donors for HLA-B antigen in the unshared HLA haplotype is warranted for HLA-mismatched/haploidentical transplantation.

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