The impact of immunogenetics and clinical factors on the outcome of unrelated cord blood transplantation: The Milano Cord Blood Bank data

Abstract In this article we examined the role of HLA incompatibility, of KIR C1 and C2 ligands and of other clinical factors on 99 cord blood transplants performed using single units from Milano Cord Blood Bank (MICB). We analyzed the occurrence of rejection, overall patient survival (OS) and occurr...

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Bibliographic Details
Published in:Transfusion and apheresis science 2010-06, Vol.42 (3), p.283-288
Main Authors: Serafini, Marta, Poli, Francesca, Torelli, Rosanna, Fleischhauer, Katharina, Zino, Elisabetta, Arias, Alejandro Espadas de, Longhi, Elena, Frison, Sara, Karpasitou, Katherina, Pezzali, Ilaria, Lecchi, Lucilla, Scalamogna, Mario
Format: Article
Language:English
Subjects:
Adolescent
Adult
Cell survival
Child
Child, Preschool
Cord blood
Cord Blood Stem Cell Transplantation - adverse effects
Data processing
Donors
Female
Graft rejection
Graft vs Host Disease - genetics
Graft vs Host Disease - immunology
Graft-versus-host reaction
Health technology assessment
Hematology, Oncology and Palliative Medicine
Histocompatibility antigen HLA
HLA-C Antigens - genetics
HLA-C Antigens - immunology
Humans
Immunogenetics
Infant
Infant, Newborn
Italy
Major histocompatibility complex
Male
Middle Aged
Receptors, KIR - genetics
Receptors, KIR - immunology
Retrospective Studies
Survival
Transplantation, Homologous - adverse effects
Young Adult
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Summary:Abstract In this article we examined the role of HLA incompatibility, of KIR C1 and C2 ligands and of other clinical factors on 99 cord blood transplants performed using single units from Milano Cord Blood Bank (MICB). We analyzed the occurrence of rejection, overall patient survival (OS) and occurrence of acute GvHD ⩾2 grade (severe aGvHD). No correlation was found between the end points and the number of HLA-A,-B, -DRB1 and -DQB1 mismatches. Only HLA-C disparities are associated with the occurrence of rejection ( P = 0.03). Our results showed that the presence of the C1 ligand in the donor decreased the occurrence of aGvHD (grade ⩾2) in the recipient while recipients of donors expressing the C2 KIR ligand experienced more frequently aGvHD ( P = 0.03). The HLA-C1 ligand, therefore, proved to have a protective effect towards severe aGvHD. The probability of rejection increased in KIR epitope-mismatched recipient/donor pairs ( P = 0.01). Finally the stage of disease at transplantation and cell dose were important for patient survival ( P = 0.003, P = 0.048 respectively).
ISSN:1473-0502
1878-1683
DOI:10.1016/j.transci.2010.03.007