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Tissue Typing

HLA matching affects clinical outcome of adult patients undergoing haematopoietic SCT from unrelated donors: a study from the Gruppo Italiano Trapianto di Midollo Osseo and Italian Bone Marrow Donor Registry

Bone Marrow Transplantation volume 44, pages 571–577 (2009)Cite this article

Abstract

The importance of HLA donor–recipient matching in unrelated haematopoietic SCT (HSCT) is the subject of debate. In this retrospective study, we analyzed 805 adult patients from the Italian Registry receiving HSCT for a haematological malignancy from January 1999 to June 2006 and correlated the degree of HLA matching with transplant outcome. All patient–donor pairs had high-resolution typing at HLA-A, -B, -C, -DRB1 and -DQB1. There was a significantly higher risk of overall mortality, non-relapse mortality, graft failure and acute GVHD (aGVHD) for patients receiving HSCT from an unrelated donor with one or more low- or high-resolution mismatch/es (Mm/s). When only a single HLA Mm is present (9/10 matched pairs), mortality risk is higher than among 10/10 matched pairs in patients transplanted with acute leukaemia in the first CR (‘early’ patients) but not in the other patients (advanced patients): HR=1.69, 95% CI=0.94–3.02, P=0.08; HR=1.03, 95% CI=0.80–1.32, P=0.82, for early and advanced patients, respectively. These results confirm that the advantage of a 10/10 match has a greater effect in early patients, thus suggesting that a 9/10 matched donor can be chosen in patients with advanced disease lacking a rapidly available 10/10 matched one.

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Acknowledgements

The following institutions (GITMO centers) contributed to the study: Division of Hematology, Ospedale ‘SS Antonio e Biagio’ Alessandria (A Levis); Division of Hematology, Nuovo Ospedale ‘Torrette’ Ancona (P Leoni); Division of Hematology, Ospedali Riuniti, Bergamo (A Rambaldi); Institute of Hematology and Clinical Oncology ‘L A Seragnoli,’ Ospedale ‘S Orsola-Malpighi,’ University of Bologna, Bologna (G Bandini, F Bonifazi); Department of Hematology, Ospedale Regionale, Bolzano (M Casini); Division of Hematology and Bone Marrow Transplantation Center, Ospedale Oncologico ‘A Businco,’ Cagliari (E Angelucci, D Baronciani); Bone Marrow Transplantation Unit, Ospedale ‘R Binagli,’ University of Cagliari, Cagliari (G La Nasa); Division of Hematology and Bone Marrow Transplantation, Ospedale ‘Ferrarotto,’ Catania (G Milone); Division of Hematology, Ospedale ‘S Croce e Carlo,’ Cuneo (N Mordini); Department of Hematology, Ospedale ‘Careggi,’ University of Florence, Firenze (S Guidi, A Bosi); Division of Hematology, Ospedale ‘S Martino,’ Genova (A Bacigalupo, M T Van Lint); Division of Hematology and Oncology, IRCCS ‘G Gaslini’, Genova (G Dini); Hematology–Bone Marrow Transplantation Unit, Istituto Nazionale dei Tumori, University of Milano, Milano (P Corradini, R Milani), Division of Hematology Ospedale ‘Cà Granda’ Niguarda, Milano (E Morra, P Marenco); Department of Hematology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano (G Lambretenghi Deliliers, F Onida); Hematology and Bone Marrow Transplantation Unit, S Raffaele Scientific Institute, Milano (F Ciceri, M Marcatti); Transplantation Unit Department of Oncology–Hematology, IRCCS Clinica Humanitas, Rozzano (L Castagna); Department of Oncology and Hematology University of Modena and Reggio Emilia, Modena (F Narni); Division of Hematology and Transplant Unit, Ospedale ‘S Gerardo,’ University of Milano-Bicocca, Monza (P Pioltelli), Division of Hematology, University of Napoli ‘Federico II’ Medical School, Napoli (C Selleri); Clinica Onco-Ematologica, University of Padova, Padova (L Zanesco); Division of Hematology and Transplant Unit, Ospedale ‘V Cervello,’ Palermo (R Scimè); Department of Oncology, Hematology Unit, Ospedale ‘La Maddalena,’ Palermo (M Musso), Division of Hematology, University of Pavia, Fondazione IRCCS Policlinico ‘S Matteo,’ Pavia (EP Alessandrino); Pediatric Hematology–Oncology University of Pavia, Fondazione IRCCS Policlinico ‘S Matteo,’ Pavia (F Locatelli); Hematology and Transplant Center, Ospedale ‘S Salvatore,’ Pesaro (G Visani); Department of Hematology, Ospedale Civile, Pescara (P Di Bartolomeo); Division of Hematology, University of Pisa, Pisa (F Papineschi); Division of Onco-Hematology, Azienda Ospedaliera Universitaria Pisana, Pisa (C Favre); Transplant Unit ‘A Neri,’ Ospedale ‘Bianchi-Melacrino-Morelli,’ Reggio Calabria (G Messina); Division of Hematology, Department of Cellular Biotechnologies and Hematology, University ‘La Sapienza’ (A P Iori, R Foà); Hematology and Stem Cell Transplantation Unit Ospedale ‘S Camillo,’ Roma (A Locasciulli, I Majolino); Hematology, University ‘S Cuore,’ Roma (P Chiusolo, G Leone); Hemato-Oncology Transplant Unit, University ‘Tor Vergata,’ Roma (W Arcese, R Cerretti); Unit of Hematology and Bone Marrow Transplantation, IRCCS, ‘Casa Sollievo della Sofferenza,’ S Giovanni Rotondo (A M Carella, N Cascavilla); Division of Hematology and Bone Marrow Transplantation, Policlinico ‘Le Scotte’, Siena (F Lauria); Institute of Hematology, Ospedale Nord, Taranto (P Mazza); Division of Hematology, Ospedale ‘S Giovanni Battista,’ Torino (M Falda); Division of Hematology, University of Torino, Ospedale ‘S Giovanni Battista,’ Torino (B Bruno, M Boccadoro); Center of Stem Cell Transplantation and Cellular Therapy, Ospedale Infantile Regina Margherita, Torino (F Fagioli); Division of Hematology and Bone Marrow Transplantation, University of Udine, Udine (R Fanin, M Cerno); Division of Hematology-Bone Marrow Transplantation Unit, Policlinico ‘GB Rossi’, Verona (F Benedetti) and Department of Hematology, Ospedale ‘S Bortolo,’ Vicenza (R Raimondi).

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Authors and Affiliations

  1. Department of Oncology, Hematology and Bone Marrow Transplantation Unit, S Raffaele Scientific Institute, Milano, Italy

    R Crocchiolo & F Ciceri

  2. Immunogenetics Laboratory, S Raffaele Scientific Institute, Milano, Italy

    K Fleischhauer

  3. Department of Hemato-Oncology, Division of Hematology, Ospedale San Martino, Genova, Italy

    R Oneto, B Bruno & A Bacigalupo

  4. Italian Bone Marrow Donor Registry, Ospedale Galliera, Genova, Italy

    S Pollichieni & N Sacchi

  5. Department of Health Sciences (DISSAL), Biostatistics Unit, University of Genova, Genova, Italy

    R Crocchiolo & M P Sormani

  6. Division of Hematology and Bone Marrow Transplantation, University of Udine, Udine, Italy

    R Fanin

  7. Institute of Hematology and Clinical Oncology ‘LA Seragnoli’, Bologna, Italy

    G Bandini & F Bonifazi

  8. Department of Hematology, University of Florence, Florence, Italy

    A Bosi

  9. Department of Oncology and Hematology, Division of Hematology, Ospedali Riuniti, Bergamo, Italy

    A Rambaldi

  10. Division of Hematology, University of Pavia, Pavia, Italy

    P E Alessandrino

  11. Division of Hematology, Ospedale San Giovanni Battista, Torino, Italy

    M Falda

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  1. R Crocchiolo
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  2. F Ciceri
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  9. R Fanin
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  10. G Bandini
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  14. P E Alessandrino
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  15. M Falda
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  16. A Bacigalupo
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Correspondence to R Crocchiolo.

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Crocchiolo, R., Ciceri, F., Fleischhauer, K. et al. HLA matching affects clinical outcome of adult patients undergoing haematopoietic SCT from unrelated donors: a study from the Gruppo Italiano Trapianto di Midollo Osseo and Italian Bone Marrow Donor Registry. Bone Marrow Transplant 44, 571–577 (2009). https://doi.org/10.1038/bmt.2009.67

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