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Histocompatibility and Donor Selection Issues

Donor–recipient allele-level HLA matching of unrelated cord blood units reveals high degrees of mismatch and alters graft selection

Bone Marrow Transplantation volume 49, pages 1184–1186 (2014)Cite this article

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Abstract

The feasibility of selecting cord blood (CB) units at high-resolution HLA match has not been investigated. We analyzed the high-resolution donor–recipient HLA match of 100 double-unit 4–6/6 HLA-A,-B antigen, -DRB1 allele-matched CB grafts (units 1a and 1b) and their back-up units (n=377 units in total). The median cryopreserved graft dose was 2.9 × 107/kg/unit, and at high resolution these units had a median donor–recipient HLA-allele match of 5/8 (range 2–8/8) and 6/10 (range 2–9/10), respectively. We then evaluated how often use of high-resolution HLA-match criteria would change the original graft selection to substitute one or both of the back-up units for units 1a and/or 1b. On using a model in which both a higher eight-allele HLA match and a cell dose ⩾2.0 × 107/kg/unit were required, graft selection changed in 33% of transplants with minimal effect on cell dose (8.3% reduction). In summary, while units chosen based on HLA-A,-B antigen and -DRB1 allele match have substantial mismatch at higher resolution, CB selection based on high-resolution HLA match is possible in a significant proportion of patients without compromise in cell dose.

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Acknowledgements

This work was supported in part by the Gabrielle’s Angel Foundation for Cancer Research, the Memorial Sloan-Kettering Cancer Center Society, the Translational and Integrative Medicine Research Grant and P01 CA23766 from the National Cancer Institute, National Institutes of Health.

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Authors and Affiliations

  1. Department of Medicine, Adult Bone Marrow Transplantation Service, New York, NY, USA,

    P B Dahi, D M Ponce, K L Evans, M Lubin, A M Gonzales, S Giralt & J N Barker

  2. Weill Cornell Medical College, New York, NY, USA

    P B Dahi, D M Ponce, S Giralt & J N Barker

  3. Department of Biostatistics, New York, NY, USA,

    S Devlin

  4. Department of Pediatrics, Bone Marrow Transplantation Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA,

    C Byam, M Sideroff, D Wells, N A Kernan & A Scaradavou

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  1. P B Dahi
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  2. D M Ponce
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  3. S Devlin
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  4. K L Evans
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  5. M Lubin
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  6. A M Gonzales
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  8. M Sideroff
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  9. D Wells
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  10. S Giralt
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  11. N A Kernan
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  12. A Scaradavou
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  13. J N Barker
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Correspondence to J N Barker.

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Dahi, P., Ponce, D., Devlin, S. et al. Donor–recipient allele-level HLA matching of unrelated cord blood units reveals high degrees of mismatch and alters graft selection. Bone Marrow Transplant 49, 1184–1186 (2014). https://doi.org/10.1038/bmt.2014.135

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  • DOI: https://doi.org/10.1038/bmt.2014.135

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