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What is the impact of HLA mismatches detected by high-resolution techniques on the outcome of unrelated donor bone marrow transplantation?

Bone Marrow Transplantation volume 35, page 1211 (2005)Cite this article

The NMDP study population2 was heterogeneous with respect to sex, age, race, center, time of treatment, graft manipulation, and other variables. While the general approach to dealing with these confounding variables was described in the paper, specific details of the analysis were not available. This makes it difficult to compare the major findings of this study with previous studies. Additionally, the statistical approach in the study to select confounding variables2 is not universally accepted.3

Whether a given HLA mismatch has an impact on transplant outcome or not depends upon the specific clinical context, including the conditioning regimen, stem cell source, GVHD prophylaxis, graft manipulation, etc. Thus, even the best attempts to correct for a myriad of possible clinical confounders using advanced statistical techniques may result in conclusions that are erratic or erroneous. HLA-DQB1 may serve as an example. The NMDP study2 would imply that HLA-DQB1 should no longer be considered a transplantation antigen. However, the only reason for this is that no effect could be identified by means of tests for statistical differences after adjustment for all possible confounders including HLA mismatches at other loci.4

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References

  1. Ottinger HD, Ferencik S, Beelen DW et al. Impact of HLA-A, B, C allele mismatches on outcome after unrelated blood stem cell transplantation in whites. Transplantation 2004; 78: 1077–1080.

    Article  CAS  Google Scholar 

  2. Flomenberg N, Baxter-Lowe LA, Confer D et al. Impact of HLA class I and class II high resolution matching on outcomes of unrelated donor bone marrow transplantation: HLA-C mismatching is associated with a strong adverse effect on transplant outcome. Blood 2004; 104: 1923–1930.

    Article  CAS  Google Scholar 

  3. Mickey RM, Greenland S . The impact of confounder selection criteria on effect estimation. Am J Epidemiol 1989; 129: 125–137 (Erratum in: Am J Epidemiol 1989; 130: 1066).

    Article  CAS  Google Scholar 

  4. Petersdorf EW, Anasetti C, Martin PJ et al. Limits of HLA matching in unrelated hematopoietic cell transplantations. Blood 2004; 104: 2976–2980.

    Article  CAS  Google Scholar 

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  1. Institute of Immunology, University Hospital of Essen, Essen, Germany

    H D Ottinger, D W Beelen & H Grosse-Wilde

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  1. H D Ottinger
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  2. D W Beelen
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  3. H Grosse-Wilde
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Ottinger, H., Beelen, D. & Grosse-Wilde, H. What is the impact of HLA mismatches detected by high-resolution techniques on the outcome of unrelated donor bone marrow transplantation?. Bone Marrow Transplant 35, 1211 (2005). https://doi.org/10.1038/sj.bmt.1704965

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