Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;28(7):398.e1-398.e9.
doi: 10.1016/j.jtct.2022.05.005. Epub 2022 May 13.

Effect of Multiple HLA Locus Mismatches on Outcomes after Single Cord Blood Transplantation

Junya Kanda  1 , Shigeki Hirabayashi  2 , Hisayuki Yokoyama  3 , Takakazu Kawase  4 , Hidenori Tanaka  5 , Naoyuki Uchida  6 , Shuichi Taniguchi  6 , Satoshi Takahashi  7 , Makoto Onizuka  8 , Masatsugu Tanaka  9 , Yasuhiro Sugio  10 , Tetsuya Eto  11 , Yoshinobu Kanda  12 , Takafumi Kimura  13 , Tatsuo Ichinohe  4 , Yoshiko Atsuta  14 , Satoko Morishima  15 ; Japanese Society for Transplantation and Cellular Therapy's HLA Working Group
Affiliations
Free article

Effect of Multiple HLA Locus Mismatches on Outcomes after Single Cord Blood Transplantation

Junya Kanda et al. Transplant Cell Ther. 2022 Jul.
Free article

Abstract

The effect of single or multiple mismatches at each HLA locus on outcomes after cord blood transplantation (CBT) is controversial. We analyzed the effects of single or multiple HLA locus mismatches on the outcomes after single CBT using Japanese registry data from the Japan Society for Hematopoietic Cell Transplantation. Patients age ≥16 years with acute leukemia and myelodysplastic syndromes who underwent their first CBT between 2003 and 2017 (n = 4074) were included. The effect of the number of HLA locus mismatches (0, 1, or 2 for the HLA-A, -B, -C, and -DRB1 loci) on outcomes was analyzed after adjusting for other significant variables. The patient cohort had a median age of 54 years. The median total nucleated and CD34 cell doses were 2.6 × 107/kg and .8 × 105/kg, respectively. The number of CBTs with single or double mismatches were 2099 and 292, respectively, for the HLA-A locus, 2699 and 341 for the HLA-B locus, 2555 and 609 for the HLA-C locus, and 2593 and 571 for the HLA-DRB1 locus. Single and double HLA-DRB1 mismatches were associated with a higher risk of grade II-IV acute graft-versus-host disease (GVHD; single: hazard ratio [HR], 1.29, P < .001; double: HR, 1.49, P < .001; P for trend <.001). Single and double mismatches at HLA-DRB1 as well as single mismatches at HLA-A and HLA-B also were associated with grade III-IV acute GVHD. Single and double HLA-B mismatches and double HLA-DRB1 mismatches were associated with a high risk of nonrelapse mortality (NRM). On the other hand, double mismatches at HLA-A or HLA-DRB1 and single mismatches at HLA-B were associated with a lower risk of relapse. HLA-DRB1 double mismatch was associated with high risk of grade II-IV and grade III-IV acute GVHD and NRM but lower risk of relapse. Not only the locus mismatch, but also the number of mismatches, should be considered in cord blood unit selection.

Keywords: Acute graft-versus-host disease; Cord blood transplantation; HLA mismatch; Nonrelapse mortality; Overall survival; Relapse.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest There are no conflicts of interest to report.

Similar articles

See all similar articles

Cited by

Publication types