Impact of the Direction of HLA Mismatch on Transplantation Outcomes in Single Unrelated Cord Blood Transplantation

Junya Kanda, Yoshiko Atsuta, Atsushi Wake, Tatsuo Ichinohe, Minoko Takanashi, Yasuo Morishima, Shuichi Taniguchi, Satoshi Takahashi, Hiroyasu Ogawa, Kazuteru Ohashi, Yuju Ohno, Nobuyuki Aotsuka, Yasushi Onishi, Koji Kato, Tokiko Nagamura-Inoue, Yoshinobu Kanda

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The impact of the direction of HLA mismatch (MM) on outcome in unrelated cord blood (UCB) transplantation has not yet been clarified. We conducted a retrospective study using national registry data on 2977 patients who underwent transplantation using a single UCB for leukemia or myelodysplastic syndrome. HLA matching was assessed by serologic data for HLA-A, -B, and -DR loci. The median age of the recipients at transplantation was 41 years (range, 0-82 years), and 2300 recipients (77%) were age ≥16 years. The 2-year overall survival rate was 0.46. The presence of MM only in the graft-versus-host direction or only in the host-versus-graft direction was not associated with overall mortality (hazard ratio [HR], 0.88; . P = .317 and HR, 0.95; . P = .670, respectively) compared with 1 bidirectional MM. This finding was consistent in both the child and adult cohorts. The presence of MM only in the graft-versus-host direction was associated with a lower incidence of nonrelapse mortality (HR, 0.65; . P = .040), significant only in the child cohort. No MM category was associated with relapse. Our findings suggest that the direction of HLA MM does not have a significant impact on overall survival after UCB transplantation.

Original languageEnglish
Pages (from-to)247-254
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number2
DOIs
Publication statusPublished - 2013 Feb 1

Keywords

  • Graft-versus-host direction
  • HLA incompatibility
  • Host-versus-graft direction
  • Nonrelapse mortality
  • Overall survival

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Kanda, J., Atsuta, Y., Wake, A., Ichinohe, T., Takanashi, M., Morishima, Y., Taniguchi, S., Takahashi, S., Ogawa, H., Ohashi, K., Ohno, Y., Aotsuka, N., Onishi, Y., Kato, K., Nagamura-Inoue, T., & Kanda, Y. (2013). Impact of the Direction of HLA Mismatch on Transplantation Outcomes in Single Unrelated Cord Blood Transplantation. Biology of Blood and Marrow Transplantation, 19(2), 247-254. https://doi.org/10.1016/j.bbmt.2012.09.017