International Journal of Hematology

DOI: 10.1007/s12185-019-02631-z Pages: 684-693

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

1. Osaka International Cancer Institute, Department of Hematology

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

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

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

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

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

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

8. Hamanomachi Hospital, Department of Hematology

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

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

11. Anjo Kosei Hospital, Department of Hematology and Oncology

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

13. Japanese Data Center for Hematopoietic Cell Transplantation

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

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

Correspondence to:
Shigeo Fuji
Tel: +81-6-6945-1181
Email: fujishige1231@gmail.com

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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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