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Stem Cell Procurement

Impact of HLA mismatch direction on outcomes after umbilical cord blood transplantation for hematological malignant disorders: a retrospective Eurocord-EBMT analysis

Bone Marrow Transplantation volume 49, pages 24–29 (2014)Cite this article

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A Corrigendum to this article was published on 04 June 2014

Abstract

HLA matching is a critical determinant of outcomes for patients who have undergone umbilical cord blood transplantation (UCBT). Data have been published on the importance of donor/recipient HLA mismatch direction on UCBT outcomes. HLA mismatch in the graft-versus-host (GVH) direction is defined as a donor homozygous at an HLA locus, while the recipient shares one HLA Ag with the donor. HLA mismatch in the host-versus-graft (HVG) direction is defined as a recipient homozygous with the donor sharing one HLA Ag. In our study we focused on confirming, using an independent population, whether transplantation outcomes would be different when HLA mismatch direction was considered. We analyzed 1565 patients who received a single-unit UCBT for malignant disease. Median age was 15 years and 72% of patients were transplanted for leukemia. In multivariate analysis, using the 5/6 HLA-matched population as reference, one or two HLA mismatches in the GVH or HVG direction were not associated with non-relapse related mortality and survival. On the basis of our results, there is no evidence to support a change in the current practice for cord blood unit selection.

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Acknowledgements

We thank the following authors for contribution: W Arcese, B Rio, K Boudjedir and M Labopin. In addition, Fernanda Volt, Wagnara Chaves and Chantal Kenzey for help with data collection. Funded in part by the Inserm grant TGIR0805. V Rocha is funded by National Institute Health Research-Biomedical Research Centres (NIHR-BRC) funding scheme.

Author information

Authors and Affiliations

  1. Eurocord, Hôpital Saint Louis, Paris, France

    R Cunha, A Ruggeri, K Boudjedir, E Gluckman & V Rocha

  2. Service d’Immunologie et Histocompatibilité, Hôpital Saint-Louis, AP-HP and Inserm UMRS940, Paris, France

    P Loiseau & D Charron

  3. Hospital Universitario La Fe, Servicio de Hematologia, Valencia, Spain

    G Sanz

  4. Hôpital Timone-Enfants, Service Hématologie Pédiatrique, Marseille, France

    G Michel

  5. Department of Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Rome, Italy

    A PaolaIori

  6. Bone Marrow Transplant Unit, Hôpital Saint Louis, Paris, France

    G Socié

  7. Rome Transplant Network, Bone Marrow Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy

    W Arcese & A Picardi

  8. Hospital Vall d'Hebron, Servicio de Hematologia Pediatrica, Barcelona, Spain

    C Dias de Heredia

  9. Hotel Dieu, Service Hématologie, Paris, France

    B Rio

  10. Dipartimento di Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, IRCCS Ospedale Bambino Gesù and University of Pavia, Rome, Italy

    F Locatelli

  11. Cord & Marrow Transplant Program, Sydney Children's Hospital, Sydney, Australia

    T A O'Brien

  12. Hôpital Claude Huriez, Service Hématologie, Lille, France

    I Yakoub-Agha

  13. Jesus Children's Hospital, Madrid, Spain

    M Angel Diaz

  14. CHU Bordeaux, Service Hématologie, Pessac, France

    N Milpied

  15. Ste-Justine Hospital, Pediatric Hematology Unit, Montreal, Canada

    H Bittencourt

  16. Hospital Amaral Carvalho, Bone Marrow Transplant Unit, Jau, Brazil

    M Pedro Souza

  17. King Faisal Specialist Hospital & Research Centre, Bone Marrow Transplant Unit, Ryad, Saudi Arabia

    M Aljurf

  18. Acute Leukemia Working Party of the European Blood and Marrow Transplant Group, Hôpital Saint Antoine, Université de Paris 7, Service Hématologie, Paris, France

    M Labopin

  19. Churchill Hospital, Hematology Unit, University of Oxford, Oxford, UK

    V Rocha

Authors
  1. R Cunha
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  2. P Loiseau
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  3. A Ruggeri
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  4. G Sanz
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  5. G Michel
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  6. A PaolaIori
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  7. G Socié
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  8. W Arcese
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  9. A Picardi
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  10. C Dias de Heredia
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  11. B Rio
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  12. F Locatelli
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  13. T A O'Brien
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  14. I Yakoub-Agha
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  15. M Angel Diaz
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  16. N Milpied
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  17. H Bittencourt
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  18. M Pedro Souza
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  19. M Aljurf
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  20. D Charron
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  21. K Boudjedir
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  22. M Labopin
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  23. E Gluckman
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  24. V Rocha
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Corresponding author

Correspondence to V Rocha.

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The authors declare no conflict of interest.

Additional information

Author contributions:

RC, PL, AR, EG and VR designed the study, prepared and analyzed data. ML analyzed data. RC, AR, EG and VR wrote the paper. GS, GM, API, GS, WA, AP, CDH, BR, FL, TOB, IY-A, MAD, NM, HB, MPS and DC provided cases for the study. RC, PL and KB prepared and verified data. All authors edited and approved the manuscript.

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Cunha, R., Loiseau, P., Ruggeri, A. et al. Impact of HLA mismatch direction on outcomes after umbilical cord blood transplantation for hematological malignant disorders: a retrospective Eurocord-EBMT analysis. Bone Marrow Transplant 49, 24–29 (2014). https://doi.org/10.1038/bmt.2013.120

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