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Histocompatibility and Donor Selection Issues

Suggestive evidence of a role of HLA-DRB4 mismatches in the outcome of allogeneic hematopoietic stem cell transplantation with HLA-10/10-matched unrelated donors: a French–Swiss retrospective study

Bone Marrow Transplantation volume 50, pages 1316–1320 (2015)Cite this article

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Abstract

We have conducted a retrospective study on 251 patients from three centers in France and Switzerland between 2004 and 2010 with the goal to evaluate the impact of HLA-DRB3/B4/B5 allele mismatching after HLA-10/10-matched unrelated allogeneic hematopoietic stem cell transplantation (HSCT). Fourteen (5.5%) patients receiving HSCT from an HLA-10/10-matched unrelated donor had a mismatched DRB4 donor, 23 (9.5%) patients had a mismatched DRB3 donor and 214 (85%) had a fully matched unrelated donor (HLA-10/10) without DRB3- or DRB4-mismatched donor. We compared the outcomes of 37 patients with a DRB3 or DRB4 mismatch with the rest of the population. The median survival for a patient without DRB3/4 mismatch was 18 months (95% confidence interval (CI), 13–29), for DRB3-mismatched patients 32 months (95% CI, 13-NR) and for DRB4-mismatched patients 7 months (95% CI, 3-NR). The multivariate analysis showed a significant impact of DRB4 mismatching on survival (Hazards ratio (HR)=2.1 (95% CI, 1.01–4.67), P=0.045), acute GvHD (HR=2.66 (95% CI, 0.99–7.09) P=0.05) and on transplant-related mortality (HR=2.8; (95% CI, 1.7−4.4) P=0.024). In the view of an impact of DRB4 locus mismatch on clinical outcome, it would be important to confirm this observation in a prospective study as it may be worth considering DRB4 in the unrelated donor selection.

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Acknowledgements

We acknowledge the contribution of Elodie Morais, Sylvie Rey and all technicians of the different laboratories, the medical and nursing staff of the three centers.

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Authors and Affiliations

  1. Department of Hematology, Groupement Hospitalier Sud, Hospices Civils de Lyon, Université Claude Bernard Lyon EST, Pierre Bénite, France

    M Detrait, S Morisset, F Barraco, A Quintela, N Tedone & M Michallet

  2. Division of Hematology, Hematology–Oncology and Bone Marrow Transplantation unit, Faculty of Medicine, Geneva University Hospital, University of Geneva, Geneva, Switzerland

    Y Chalandon

  3. Department of Hematology, Service des maladies du sang, CHR Lille, Lille, France

    I Yakoub-Agha

  4. Laboratory for Histocompatibility, Etablissement Français du Sang, Lille, France

    F Dufossé, M Labalette, I Top & V Elsermans

  5. Société Française de Greffe de Moelle et de thérapie cellulaire, SFGM-TC Data Management, CHLS, pavillon Marcel Berard, Pierre Benite, France

    N Raus

  6. Transplantation Immunology Unit, National Reference Laboratory for Histocompatibility, Geneva University Hospitals, University of Geneva, Geneva, Switzerland

    J-M Tiercy

  7. Transplantation Immunology Unit, Laboratory for Histocompatibility, Etablissement Français du Sang, Lyon, France

    V Dubois

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  1. M Detrait
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  2. S Morisset
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  7. I Top
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  13. N Raus
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  14. J-M Tiercy
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  15. V Dubois
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Correspondence to M Detrait.

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Detrait, M., Morisset, S., Chalandon, Y. et al. Suggestive evidence of a role of HLA-DRB4 mismatches in the outcome of allogeneic hematopoietic stem cell transplantation with HLA-10/10-matched unrelated donors: a French–Swiss retrospective study. Bone Marrow Transplant 50, 1316–1320 (2015). https://doi.org/10.1038/bmt.2015.157

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