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Short-term clinical outcomes after HLA 1-locus mismatched uPBSCT are similar to that after HLA-matched uPBSCT and uBMT.
International Journal of Hematology ( IF 1.7 ) Pub Date : 2019-03-17 , DOI: 10.1007/s12185-019-02631-z
Shigeo Fuji 1 , Koichi Miyamura 2 , Yoshinobu Kanda 3 , Takahiro Fukuda 4 , Takeshi Kobayashi 5 , Yukiyasu Ozawa 2 , Koji Iwato 6 , Naoyuki Uchida 7 , Tetsuya Eto 8 , Takashi Ashida 9 , Takehiko Mori 10 , Masashi Sawa 11 , Tatsuo Ichinohe 12 , Yoshiko Atsuta 13, 14 , Junya Kanda 15 ,
Affiliation  

In Japan, use of unrelated peripheral blood stem cell transplantation (uPBSCT) from HLA-mismatched unrelated donors has recently been approved. We compared outcomes between HLA-matched and 1-locus mismatched uPBSCT, as well as the impact of HLA disparity in uPBSCT and in unrelated bone marrow transplantation (uBMT). In total, 5862 uBMT recipients and 234 uPBSCT recipients were included. In terms of HLA allele disparity, 185 uPBSCT patients (79.1%) had no HLA mismatch, and 49 (20.9%) had 1-locus mismatch; in comparison, 3585 uBMT patients (61.2%) had no HLA mismatch, and 2277 (38.8%) had 1-locus mismatch. The impact of 1-locus mismatch as compared with match in uPBSCT was not significantly higher than in uBMT [hazard ratio (HR) = 1.02 and 1.27 for grade III-IV acute graft-versus-host disease, HR = 0.98 and 1.14 for non-relapse mortality, and HR = 0.87 and 1.06 for overall survival, respectively]. In conclusion, the impact of single-locus mismatch on short-term outcomes was comparable in uPBSCT and uBMT. Larger studies with longer follow-up are needed to assess long-term outcomes.

中文翻译:

HLA 1位错配的uPBSCT后的短期临床预后与HLA匹配的uPBSCT和uBMT后的短期临床预后相似。

在日本,最近已批准使用来自HLA不匹配的无关供者的无关外周血干细胞移植(uPBSCT)。我们比较了HLA匹配和1位错配的uPBSCT之间的转归,以及HLA差异对uPBSCT和无关骨髓移植(uBMT)的影响。总共包括5862位uBMT接受者和234位uPBSCT接受者。就HLA等位基因差异而言,185例uPBSCT患者(79.1%)没有HLA错配,49例(20.9%)有1位错配。相比之下,3585例无BMT的患者(61.2%)没有HLA失配,2277例(38.8%)的1位错配。1-位错配的影响与uPBSCT中的匹配相比没有显着高于uBMT [III-IV级急性移植物抗宿主病的风险比(HR)= 1.02和1.27,非III-IV级急性移植物抗宿主病的HR = 0.98和1.14复发死亡率,HR = 0。总生存率分别为87和1.06]。总之,在uPBSCT和uBMT中,单基因位错配对短期结局的影响相当。需要更大的研究和更长的随访来评估长期结果。
更新日期:2019-03-15
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