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High-resolution HLA matching in double-umbilical-cord-blood reduced-intensity transplantation in adults |
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| Authors: | Meghan Delaney Corey S. Cutler Richard L. Haspel Beow Y. Yeap Steven L. McAfee Bimalangshu R. Dey Eyal Attar Grace Kao Edwin P. Alyea John Koreth Vincent T. Ho Susan Saidman Deborah Liney Doreen Sese Robert J. Soiffer Thomas R. Spitzer Joseph H. Antin Karen K. Ballen |
| Affiliation: | From the Puget Sound Blood Center, Seattle, Washington;the Hematology/Oncology Division, Department of Medicine, and the Histocompatibility Laboratory, Massachusetts General Hospital;Medical Oncology/Hematological Malignancies, Dana Farber Cancer Institute;the Pathology Department, Beth Israel Deaconess Medical Center;and the Tissue Typing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts |
| Abstract: | BACKGROUND: Double-cord-blood transplantation (DCBT) offers an option for patients receiving reduced-intensity transplants. These unique transplants have two donors, both of whom are usually HLA mismatched at one to two loci. STUDY DESIGN AND METHODS: Fifty-three patients were recipients of a reduced-intensity DCBT. Cords were at least 4/6 allele-level HLA-A, -B, and -DR match with the patient and each other with a minimum combined cell dose of more than 3.7 × 10 RESULTS: Neutrophil (p = 0.001) engraftment and platelet engraftment (p = 0.027) were significantly faster in patients who have closer Class I (HLA-A, -B, -C) matching. Neutrophil engraftment was faster in patients who had closer HLA-B matching to their combined cords (p = 0.007). There was a low incidence of aGVHD overall, especially in the SIR/TAC group. Class I HLA matching had no effect on aGVHD. HLA-DR and -DQ had no effect on engraftment or aGVHD. CONCLUSION: Class I allele matching, and HLA-B matching specifically, were associated with faster neutrophil engraftment. High-resolution HLA matching did not affect OS or DFS. |
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