The importance of donor-recipient human leukocyte antigen (HLA)-DPB1 matching for the clinical outcome of unrelated hematopoietic stem cell transplantation (HSCT) is controversial. We have previously described an algorithm for nonpermissive HLA-DPB1 disparities involving HLA-DPB1*0901,*1001,*1701,*0301,*1401,*4501, based on T-cell alloreactivity patterns. By revisiting the immunogenicity of HLA-DPB1*02, a modified algorithm was developed and retrospectively tested in 621 unrelated HSCTs facilitated through the Italian Registry for onco-hematologic adult patients. The modified algorithm proved to be markedly more predictive of outcome than the original one, with significantly higher KaplanMeier probabilities of 2-year survival in permissive compared with nonpermissive transplantations (55% vs 39%, P = .005). This was the result of increased adjusted hazards of nonrelapse mortality (hazard ratio [HR] = 1.74; confidence interval [CI], 1.19-2.53; P = .004) but not of relapse (HR = 1.02; CI, 0.73-1.42; P = .92). The increase in the hazards of overall mortality by nonpermissive HLA-DPB1 disparity was similar in 10 of 10 (HR = 2.12; CI, 1.23-3.64; P = .006) and 9 of 10 allele-matched transplantations (HR = 2.21; CI, 1.28-3.80; P = .004), both in early-stage and in advanced-stage disease. These data call for revisiting current HLA matching strategies for unrelated HSCT, suggesting that searches should be directed up-front toward identification of HLA-DPB1 permissive, 10 of 10 or 9 of 10 matched donors. (Blood. 2009; 114:1437-1444)
Nonpermissive HLA-DPB1 disparity is a significant independent risk factor for mortality after unrelated hematopoietic stem cell transplantation / Crocchiolo, R.; Zino, E.; Vago, L.; Oneto, R.; Bruno, B.; Pollichieni, S.; Sacchi, N.; Sormani, M. P.; Marcon, J.; Lamparelli, T.; Fanin, R.; Garbarino, L.; Miotti, V.; Bandini, G.; Bosi, A.; Ciceri, F.; Bacigalupo, A.; Fleischhauer, K.; Midollo Osseo Gruppo Italiano Trapianto, D. I.; Terapia Cellulare, Cellule Staminali Ematopoietiche Cse E.; Italian Bone Marrow Donor Registry Collaboratori, Scalari P.; Bontempelli, M.; Prinoth, O.; Carcassi, C.; Marceno, R.; Porfirio, ; Rombola, G.; Garbarino, L.; Lombardo, ; Ferrioli, G.; Poli, F.; Scalamogna, M.; Fleischhauer, K.; Mazzi, B.; Rossi, F.; Mascaretti, L.; Albergoni, ; Salvaneschi, L.; Salvaneschi, M.; Valentini, ; Nesci, S.; Papola, F.; Scatena, Mariotti; Perrone, Laurenti; Grammatico, Paola; Mariani, M.; Favoino, B.; Miotti, V.; Guizzardi, Pontiero; Leoni, P.; Rambaldi, A.; Casini, M.; Angelucci, E.; Baronciani, D.; La Nasa, G.; Milone, G.; Guidi, S.; Bosi, A.; Bacigalupo, A.; Van Lint, M. T.; Dini, G.; Corradini, P.; Milani, R.; Morra, E.; Marenco, P.; Deliliers, Lambretenghi G.; Onida, F.; Ciceri, F.; Marcatti, M.; Castagna, L.; Pioltelli, P.; Selleri, C.; Zanesco, L.; Scime, R.; Musso, M.; Alessandrino, E. P.; Locatelli, F.; Visani, G.; Di Bartolomeo, P.; Papineschi, F.; Favre, C.; Iori, A. P.; Foa, Roberto; Locasciulli, A.; Majolino, I.; Majolino, P.; Leone, G.; Arcese, W.; Cerretti, R.; Carella, A. M.; Cascavilla, N.; Lauria, F.; Mazza, P.; Fanin, R.; Cerno, M.; Benedetti, F.. - In: BLOOD. - ISSN 0006-4971. - STAMPA. - 114:7(2009), pp. 1437-1444. [10.1182/blood-2009-01-200378]
Nonpermissive HLA-DPB1 disparity is a significant independent risk factor for mortality after unrelated hematopoietic stem cell transplantation
GRAMMATICO, Paola;F. Locatelli;FOA, Roberto;
2009
Abstract
The importance of donor-recipient human leukocyte antigen (HLA)-DPB1 matching for the clinical outcome of unrelated hematopoietic stem cell transplantation (HSCT) is controversial. We have previously described an algorithm for nonpermissive HLA-DPB1 disparities involving HLA-DPB1*0901,*1001,*1701,*0301,*1401,*4501, based on T-cell alloreactivity patterns. By revisiting the immunogenicity of HLA-DPB1*02, a modified algorithm was developed and retrospectively tested in 621 unrelated HSCTs facilitated through the Italian Registry for onco-hematologic adult patients. The modified algorithm proved to be markedly more predictive of outcome than the original one, with significantly higher KaplanMeier probabilities of 2-year survival in permissive compared with nonpermissive transplantations (55% vs 39%, P = .005). This was the result of increased adjusted hazards of nonrelapse mortality (hazard ratio [HR] = 1.74; confidence interval [CI], 1.19-2.53; P = .004) but not of relapse (HR = 1.02; CI, 0.73-1.42; P = .92). The increase in the hazards of overall mortality by nonpermissive HLA-DPB1 disparity was similar in 10 of 10 (HR = 2.12; CI, 1.23-3.64; P = .006) and 9 of 10 allele-matched transplantations (HR = 2.21; CI, 1.28-3.80; P = .004), both in early-stage and in advanced-stage disease. These data call for revisiting current HLA matching strategies for unrelated HSCT, suggesting that searches should be directed up-front toward identification of HLA-DPB1 permissive, 10 of 10 or 9 of 10 matched donors. (Blood. 2009; 114:1437-1444)I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
