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Short-term clinical outcomes after HLA 1-locus mismatched uPBSCT are similar to that after HLA-matched uPBSCT and uBMT

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Abstract

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.

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Acknowledgements

This study was supported by Health, Labour and Welfare Science Grants for Research on Measures for Rare and Intractable Diseases from the Japanese Government.

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Authors and Affiliations

  1. Department of Hematology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka, 541-8567, Japan

    Shigeo Fuji

  2. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Koichi Miyamura & Yukiyasu Ozawa

  3. Division of Hematology, Saitama Medical Center Jichi Medical University, Saitama, Japan

    Yoshinobu Kanda

  4. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  5. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Takeshi Kobayashi

  6. Department of Hematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Koji Iwato

  7. Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  8. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  9. Division of Hematology and Rheumatology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osaka, Japan

    Takashi Ashida

  10. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Takehiko Mori

  11. Department of Hematology and Oncology, Anjo Kosei Hospital, Nagoya, Japan

    Masashi Sawa

  12. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  13. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  14. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

  15. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junya Kanda

Authors
  1. Shigeo Fuji
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  2. Koichi Miyamura
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  3. Yoshinobu Kanda
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  4. Takahiro Fukuda
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  5. Takeshi Kobayashi
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  9. Tetsuya Eto
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  10. Takashi Ashida
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  11. Takehiko Mori
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  13. Tatsuo Ichinohe
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  14. Yoshiko Atsuta
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  15. Junya Kanda
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the HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation

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Correspondence to Shigeo Fuji.

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Fuji, S., Miyamura, K., Kanda, Y. et al. Short-term clinical outcomes after HLA 1-locus mismatched uPBSCT are similar to that after HLA-matched uPBSCT and uBMT. Int J Hematol 109, 684–693 (2019). https://doi.org/10.1007/s12185-019-02631-z

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  • DOI: https://doi.org/10.1007/s12185-019-02631-z

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