کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5524154 | 1546248 | 2016 | 7 صفحه PDF | دانلود رایگان |
- For patients with homozygous haplotypes, haploidentical donors have no GVH mismatch.
- Transplant outcomes were similar between hetero-to-homo and matched sibling HCT.
- Incidences of acute GVHD and NRM were low after homo-to-homo transplantation.
- Hetero-to-homo transplantation without T cell depletion is a viable option.
More than 1% of the Japanese population has HLA-homozygous haplotypes. For patients with such haplotypes, HLA-haploidentical family members who have no HLA mismatch in the graft-versus-host direction are readily available donor candidates for hematopoietic cell transplantation (HCT). In this study, the outcomes of patients with homozygous HLA-A, -B, and -DRB1 antigens who received HCT without T cell depletion from a haploidentical related donor with mismatches in the host-versus-graft direction only (hetero-to-homo, nâ=â78) or from an HLA-matched sibling donor (MSD) (MSD-homo, nâ=â153) were compared with those in patients with heterozygous haplotypes who received HCT from an MSD (MSD-hetero, nâ=â7242). Transplant outcomes in the hetero-to-homo group were similar to those in the MSD-hetero group regarding neutrophil engraftment, grades III to IV acute graft-versus-host disease (aGVHD), nonrelapse mortality (NRM), relapse, and overall survival. On the other hand, the incidences of severe aGVHD and NRM in the MSD-homo group were significantly lower than those in the MSD-hetero group (grades III to IV aGVHD: aHR .50, Pâ=â.034; NRM: aHR .48, Pâ=â.004). In conclusion, patients with HLA-homozygous haplotypes achieved lower GVHD and NRM rates for MSD transplantation than those with HLA-heterozygous haplotypes. When an MSD or an appropriate alternative donor is not available for patients with HLA-homozygous haplotypes who need immediate transplantation, transplantation from a haploidentical donor without T cell depletion is a viable option, given the comparable transplant outcomes for hetero-to-homo HCT and MSD-hetero HCT.
Journal: Biology of Blood and Marrow Transplantation - Volume 22, Issue 11, November 2016, Pages 2031-2037