High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation
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- Stephanie J. Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA;
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- John Klein
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee;
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- Michael Haagenson
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN;
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- Lee Ann Baxter-Lowe
- Department of Surgery, University of California, San Francisco;
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- Dennis L. Confer
- National Marrow Donor Program, Minneapolis, MN;
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- Mary Eapen
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee;
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- Marcelo Fernandez-Vina
- M. D. Anderson Cancer Center, Houston, TX;
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- Neal Flomenberg
- Thomas Jefferson University Hospital, Philadelphia, PA;
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- Mary Horowitz
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee;
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- Carolyn K. Hurley
- Department of Oncology, Georgetown University Medical Center, Washington, DC;
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- Harriet Noreen
- Immunology/Histocompatibility Laboratory, University of Minnesota Medical Center, Fairview;
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- Machteld Oudshoorn
- Europdonor Foundation, Leiden, the Netherlands;
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- Effie Petersdorf
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA;
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- Michelle Setterholm
- National Marrow Donor Program, Minneapolis, MN;
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- Stephen Spellman
- National Marrow Donor Program, Minneapolis, MN;
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- Daniel Weisdorf
- Blood and Marrow Transplantation (BMT) Program, University of Minnesota, Minneapolis;
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- Thomas M. Williams
- Department of Pathology, University of New Mexico, Albuquerque; and
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- Claudio Anasetti
- H. Lee Moffitt Cancer Center, Tampa, FL
書誌事項
- 公開日
- 2007-12-15
- DOI
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- 10.1182/blood-2007-06-097386
- 公開者
- American Society of Hematology
この論文をさがす
説明
<jats:p>The relative importance of various human leukocyte antigen (HLA) loci and the resolution level at which they are matched has not been fully defined for unrelated donor transplantation. To address this question, National Marrow Donor Program data from 3857 transplantations performed from 1988 to 2003 in the United States were analyzed. Patient-donor pairs were fully typed for HLA-A, -B, -C, -DRB1, -DQB1, -DQA1, -DPB1, and -DPA1 alleles. High-resolution DNA matching for HLA-A, -B, -C, and -DRB1 (8/8 match) was the minimum level of matching associated with the highest survival. A single mismatch detected by low- or high-resolution DNA testing at HLA-A, -B, -C or -DRB1 (7/8 match) was associated with higher mortality (relative risk, 1.25; 95% CI, 1.13-1.38; P < .001) and 1-year survival of 43% compared with 52% for 8/8 matched pairs. Single mismatches at HLA-B or HLA-C appear better tolerated than mismatches at HLA-A or HLA-DRB1. Mismatching at 2 or more loci compounded the risk. Mismatching at HLA-DP or -DQ loci and donor factors other than HLA type were not associated with survival. In multivariate modeling, patient age, race, disease stage, and cytomegalovirus status were as predictive of survival as donor HLA matching. High-resolution DNA matching for HLA-A, -B, -C, and -DRB1 alleles is associated with higher rates of survival.</jats:p>
収録刊行物
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- Blood
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Blood 110 (13), 4576-4583, 2007-12-15
American Society of Hematology