Donor-recipient allele-level HLA matching of unrelated cord blood units reveals high degrees of mismatch and alters graft selection Journal Article


Authors: Dahi, P. B.; Ponce, D. M.; Devlin, S.; Evans, K. L.; Lubin, M.; Gonzales, A. M.; Byam, C.; Sideroff, M.; Wells, D.; Giralt, S.; Kernan, N. A.; Scaradavou, A.; Barker, J. N.
Article Title: Donor-recipient allele-level HLA matching of unrelated cord blood units reveals high degrees of mismatch and alters graft selection
Abstract: The feasibility of selecting cord blood (CB) units at high-resolution HLA match has not been investigated. We analyzed the high-resolution donor-recipient HLA match of 100 double-unit 4-6/6 HLA-A,-B antigen, -DRB1 allele-matched CB grafts (units 1a and 1b) and their back-up units (n = 377 units in total). The median cryopreserved graft dose was 2.9 x 10(7)/kg/unit, and at high resolution these units had a median donor-recipient HLA-allele match of 5/8 (range 2-8/8) and 6/10 (range 2-9/10), respectively. We then evaluated how often use of high-resolution HLA-match criteria would change the original graft selection to substitute one or both of the back-up units for units 1a and/or 1b. On using a model in which both a higher eight-allele HLA match and a cell dose >= 2.0 x 10(7)/kg/unit were required, graft selection changed in 33% of transplants with minimal effect on cell dose (8.3% reduction). In summary, while units chosen based on HLA-A,-B antigen and -DRB1 allele match have substantial mismatch at higher resolution, CB selection based on high-resolution HLA match is possible in a significant proportion of patients without compromise in cell dose.
Keywords: hematologic malignancy; outcomes; impact; stem-cell transplantation; retrospective analysis; bone-marrow; acute-leukemia
Journal Title: Bone Marrow Transplantation
Volume: 49
Issue: 9
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2014-09-01
Start Page: 1184
End Page: 1186
Language: English
ACCESSION: WOS:000341786700008
DOI: 10.1038/bmt.2014.135
PROVIDER: wos
PUBMED: 25000459
PMCID: PMC4367540
Notes: Article -- Source: Wos
Altmetric Score
MSK Authors
  1. Nancy Kernan
    369 Kernan
  2. Sergio Andres Giralt
    515 Giralt
  3. Doris Ponce
    129 Ponce
  4. Juliet N Barker
    224 Barker
  5. Marissa N Lubin
    77 Lubin
  6. Katherine Lee Evans
    24 Evans
  7. Sean McCarthy Devlin
    287 Devlin
  8. Deborah Sessions Wells
    15 Wells
  9. Parastoo Bahrami Dahi
    78 Dahi