Marrow Transplantation From Unrelated Donors for Treatment of Hematologic Malignancies: Effect of Mismatching for One HLA Locus

One hundred twelve patients less than 36 years old received marrow grafts from unrelated donors as treatment for hematologic malignancy. Seventy donor/recipient pairs were phenotypically identical for H LA-A, -B, and -D, while 42 had a “minor” disparity at one HLA locus. There was an increase in the...

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Bibliographic Details
Published in:Blood 1993-01, Vol.81 (1), p.249-253
Main Authors: Beatty, Patrick G., Anasetti, Claudio, Hansen, John A., Longton, Gary M., Sanders, Jean E., Martin, Paul J., Mickelson, Eric M., Choo, S. Yoon, Petersdorf, Effie W., Pepe, Margaret S., Appelbaum, Frederick R., Bearman, Scott I., Buckner, C. Dean, Gift, Reginald A., Petersen, Finn Bo, Singer, Jack, Stewart, Patricia S., Storb, Rainer F., Sullivan, Keith M., Tesler, Michele C., Witherspoon, Robert P., Thomas, E. Donnall
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Bone Marrow Transplantation
Bone marrow, stem cells transplantation. Graft versus host reaction
Chronic Disease
Graft vs Host Disease - immunology
Histocompatibility
Histocompatibility Testing
HLA Antigens - analysis
Humans
Leukemia - mortality
Leukemia - surgery
Medical sciences
Neoplasm Recurrence, Local
Risk Factors
Survival Rate
Tissue Donors
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
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Summary:One hundred twelve patients less than 36 years old received marrow grafts from unrelated donors as treatment for hematologic malignancy. Seventy donor/recipient pairs were phenotypically identical for H LA-A, -B, and -D, while 42 had a “minor” disparity at one HLA locus. There was an increase in the risk of acute graft-versus-host disease (GVHD) in patients receiving HLA-partially matched grafts compared with those receiving HLA-matched grafts (51% v 36% probability of grades III-IV acute GVHD). However, in this cohort of patients, there was no significant difference in survival (at 1.5 years, 46% v 51% for good-risk patients, 44% v 30% for poor-risk patients). This finding suggests that some degree of HLA disparity can be tolerated in young patients transplanted from unrelated donors for malignant disease, thus making transplantation an option available to larger numbers of patients.
ISSN:0006-4971
1528-0020
DOI:10.1182/blood.V81.1.249.249