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Pediatric Transplants

Improved survival in matched unrelated donor transplant for childhood ALL since the introduction of high-resolution matching at HLA class I and II

Bone Marrow Transplantation volume 47, pages 1294–1300 (2012)Cite this article

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Abstract

We present the first detailed study analysing OS in BMT for paediatric ALL following the introduction of high-resolution (HR) HLA matching. A total of 356 consecutive paediatric ALL stem cell transplants performed between 1988 and 2007 were reviewed; 80 of them were performed following the introduction of HR HLA class I and class II matching to the transplant programme in 2002. Comparisons of matched unrelated donor (MUD) transplant outcomes before and after this period were made. Matching at the HR level for HLA-A, -B, -C, -DRB1 and -DQB1 (HR-MUD) correlated with a greater than 25% improvement in 2- and 5-year OS in paediatric ALL patients transplanted with MUDs (P=0.009, P=0.005, respectively). Two-year OS for contemporaneous HLA-matched sibling transplants (80.8%) and HR-MUD transplants (78.8%) was equivalent. At 6%, non-relapse mortality (NRM) in MUD transplants since 2002 was significantly reduced compared with previous epochs. Changes in treatment and epoch-dependent improvements in outcome were reviewed for possible confounders to the influence of HR typing using univariate and multivariate analysis.

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Acknowledgements

We are grateful to the staff of the Histocompatibility and Immunogenetics Department, NHS Blood and Transplant, Bristol and the medical, nursing and support staff at the stem cell transplant unit of the Bristol Royal Hospital for Children without whose dedication this study would not have been possible.

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Authors and Affiliations

  1. Histocompatibility and Immunogenetics Department, NHS Blood and Transplant, Bristol, UK

    J Harvey, A Green, L Keen, S Culliford, A Poles & Y Li

  2. Bristol Royal Hospital for Children, Department of Paediatric Oncology Bristol, UK

    J Cornish, C Steward, M Cummins, L Hunt, P Breslin & J Moppett

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  1. J Harvey
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  2. A Green
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  3. J Cornish
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  4. C Steward
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  7. S Culliford
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  8. A Poles
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  10. P Breslin
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Correspondence to J Moppett.

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Harvey, J., Green, A., Cornish, J. et al. Improved survival in matched unrelated donor transplant for childhood ALL since the introduction of high-resolution matching at HLA class I and II. Bone Marrow Transplant 47, 1294–1300 (2012). https://doi.org/10.1038/bmt.2012.8

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  • DOI: https://doi.org/10.1038/bmt.2012.8

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