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The role of HLA matching in unrelated donor hematopoietic stem cell transplantation for sickle cell disease in Europe

We report the results of an analysis of unrelated allogeneic hematopoietic stem cell transplantations (HSCT) in 71 patients with sickle cell disease (SCD) transplanted in EBMT centers between 2005 and 2017. Median age was 9.3 years; graft type was bone marrow in 79% and peripheral blood in 21%. Reci...

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Published in:Bone marrow transplantation (Basingstoke) 2020-10, Vol.55 (10), p.1946-1954
Main Authors: Gluckman, Eliane, Fuente, Josu de la, Cappelli, Barbara, Scigliuolo, Graziana M., Volt, Fernanda, Tozatto-Maio, Karina, Rocha, Vanderson, Tommaso, Mina, O’Boyle, Farah, Smiers, Frans, Cunha-Riehm, Claudia Bettoni Da, Calore, Elisabetta, Bonanomi, Sonia, Graphakos, Stelios, Paisiou, Anna, Albert, Michael H., Ruggeri, Annalisa, Zecca, Marco, Lankester, Arjan C., Corbacioglu, Selim
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cited_by cdi_FETCH-LOGICAL-c513t-dd2fb4dd4c585af5a6bb1db057c65cba735a34e41d221ade1ce1ce5593b638da3
cites cdi_FETCH-LOGICAL-c513t-dd2fb4dd4c585af5a6bb1db057c65cba735a34e41d221ade1ce1ce5593b638da3
container_end_page 1954
container_issue 10
container_start_page 1946
container_title Bone marrow transplantation (Basingstoke)
container_volume 55
creator Gluckman, Eliane
Fuente, Josu de la
Cappelli, Barbara
Scigliuolo, Graziana M.
Volt, Fernanda
Tozatto-Maio, Karina
Rocha, Vanderson
Tommaso, Mina
O’Boyle, Farah
Smiers, Frans
Cunha-Riehm, Claudia Bettoni Da
Calore, Elisabetta
Bonanomi, Sonia
Graphakos, Stelios
Paisiou, Anna
Albert, Michael H.
Ruggeri, Annalisa
Zecca, Marco
Lankester, Arjan C.
Corbacioglu, Selim
description We report the results of an analysis of unrelated allogeneic hematopoietic stem cell transplantations (HSCT) in 71 patients with sickle cell disease (SCD) transplanted in EBMT centers between 2005 and 2017. Median age was 9.3 years; graft type was bone marrow in 79% and peripheral blood in 21%. Recipient–donor HLA match at high resolution typing was 10/10 in 31, 9/10 in 20, and 8/10 in 4 patients; the other patients had intermediate resolution typing. The most frequent conditioning regimens were fludarabine–thiotepa–treosulfan (64%) or busulfan–cyclophosphamide (12%). Cumulative incidence of neutrophil engraftment was 92%; platelet engraftment was 90%. Eleven patients (15%) experienced graft failure. Grade II–IV acute graft-vs.-host disease (GvHD) was 23%; 3-year chronic GvHD was 23%. Three-year overall survival (OS) was 88 ± 4%. GRFS was 62 ± 6%. HLA matching was the most significant risk factor for OS: 3-year OS was 96 ± 4% in 10/10 group vs. 75 ± 10% in 9–8/10 ( p  = 0.042); GRFS was 69 ± 9% vs. 50 ± 12% ( p  = 0.114), respectively. In conclusion, unrelated donor HSCT is a valid option for SCD patients who lack an HLA-identical sibling donor, preferably in the context of clinical trials. Using a 10/10 HLA-matched unrelated donor yields better survival indicating that HLA matching is an important donor selection factor in this nonmalignant disease.
doi_str_mv 10.1038/s41409-020-0847-z
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In conclusion, unrelated donor HSCT is a valid option for SCD patients who lack an HLA-identical sibling donor, preferably in the context of clinical trials. 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In conclusion, unrelated donor HSCT is a valid option for SCD patients who lack an HLA-identical sibling donor, preferably in the context of clinical trials. 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Median age was 9.3 years; graft type was bone marrow in 79% and peripheral blood in 21%. Recipient–donor HLA match at high resolution typing was 10/10 in 31, 9/10 in 20, and 8/10 in 4 patients; the other patients had intermediate resolution typing. The most frequent conditioning regimens were fludarabine–thiotepa–treosulfan (64%) or busulfan–cyclophosphamide (12%). Cumulative incidence of neutrophil engraftment was 92%; platelet engraftment was 90%. Eleven patients (15%) experienced graft failure. Grade II–IV acute graft-vs.-host disease (GvHD) was 23%; 3-year chronic GvHD was 23%. Three-year overall survival (OS) was 88 ± 4%. GRFS was 62 ± 6%. HLA matching was the most significant risk factor for OS: 3-year OS was 96 ± 4% in 10/10 group vs. 75 ± 10% in 9–8/10 ( p  = 0.042); GRFS was 69 ± 9% vs. 50 ± 12% ( p  = 0.114), respectively. In conclusion, unrelated donor HSCT is a valid option for SCD patients who lack an HLA-identical sibling donor, preferably in the context of clinical trials. Using a 10/10 HLA-matched unrelated donor yields better survival indicating that HLA matching is an important donor selection factor in this nonmalignant disease.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>32157246</pmid><doi>10.1038/s41409-020-0847-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-8818-1744</orcidid><orcidid>https://orcid.org/0000-0002-0974-1249</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0268-3369
ispartof Bone marrow transplantation (Basingstoke), 2020-10, Vol.55 (10), p.1946-1954
issn 0268-3369
1476-5365
language eng
recordid cdi_proquest_miscellaneous_2376231052
source Nexis UK; Springer Link
subjects 13/100
692/699/1541
692/700/565/2319
Analysis
Antithymocyte globulin
Bone marrow
Bone marrow transplantation
Busulfan
Cell Biology
Clinical trials
Cyclophosphamide
Fludarabine
Graft rejection
Graft-versus-host reaction
Grafting
Grafts
Hematology
Hematopoietic stem cells
Histocompatibility antigen HLA
Internal Medicine
Matching
Medicine
Medicine & Public Health
Peripheral blood
Public Health
Risk analysis
Risk factors
Sickle cell anemia
Sickle cell disease
Stem cell transplantation
Stem Cells
Survival
Tissue typing
Transplantation
Treosulfan
title The role of HLA matching in unrelated donor hematopoietic stem cell transplantation for sickle cell disease in Europe
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