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Histocompatibility and Donor Selection Issues

Impact of HLA allele mismatch on the clinical outcome in serologically matched related hematopoietic SCT

Bone Marrow Transplantation volume 49, pages 1187–1192 (2014)Cite this article

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Abstract

In unrelated hematopoietic SCT (HSCT), HLA allele mismatch has been shown to have a significant role. To clarify the importance of HLA allele mismatch in the GVH direction in related HSCT, we retrospectively evaluated 2377 patients who received stem cells from an HLA serologically matched related donor in the GVH direction using the database of the Japan Society for Hematopoietic Cell Transplantation. The cumulative incidences of grade II–IV and grade III–IV acute GVHD in patients with an HLA allele-mismatched donor (n=133, 5.6%) were significantly higher than those in patients with an HLA allele-matched donor. Multivariate analyses showed that the presence of HLA allele mismatch was associated with increased risks of grade II–IV and grade III–IV acute GVHD. In particular, HLA-B mismatch and multiple allele mismatches were associated with an increased risk of acute GVHD. The presence of HLA allele mismatch was associated with an inferior OS owing to an increased risk of non-relapse mortality (NRM). In conclusion, the presence of HLA allele mismatch in the GVH direction in related HSCT was associated with increased risks of GVHD and NRM, which led to an inferior OS. HLA allele typing is recommended in related HSCT.

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Acknowledgements

This work was supported in part by a Grant-in-Aid from the Ministry of Health, Labor and Welfare of Japan. We thank all the physicians and data managers at the centers who contributed valuable data on transplantation to the JSHCT. We also thank all the members of the data management committees of the JSHCT for their contributions.

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Authors and Affiliations

  1. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    S Fuji

  2. Division of Hematology, Saitama Medical Center, Saitama, Japan

    J Kanda & Y Kanda

  3. Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan

    S Kato

  4. Division of Hematology, Department of Internal Medicine, Hyogo Medical College, Hyogo, Japan

    K Ikegame

  5. Department of Hematology, Fujita Health University School of Medicine, Nagoya, Japan

    S Morishima

  6. Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka, Japan

    T Miyamoto

  7. Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

    M Hidaka

  8. Department of Hematology, Aomori Prefectural Central Hospital, Aomori, Japan

    K Kubo

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

    K Miyamura

  10. Hematology Division, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan

    K Ohashi

  11. Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan

    H Kobayashi

  12. Department of Hematology, Tenri Hospital, Nara, Japan

    Y Maesako

  13. Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan

    S Adachi

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

    T Ichinohe

  15. Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Y Atsuta

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  1. S Fuji
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  2. J Kanda
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  7. M Hidaka
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  8. K Kubo
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  9. K Miyamura
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  10. K Ohashi
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  12. Y Maesako
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  13. S Adachi
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  14. T Ichinohe
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  15. Y Atsuta
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  16. Y Kanda
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on behalf of the HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation

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Correspondence to Y Kanda.

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Fuji, S., Kanda, J., Kato, S. et al. Impact of HLA allele mismatch on the clinical outcome in serologically matched related hematopoietic SCT. Bone Marrow Transplant 49, 1187–1192 (2014). https://doi.org/10.1038/bmt.2014.141

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  • DOI: https://doi.org/10.1038/bmt.2014.141

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