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Comparison of the clinical outcomes between NIMA-mismatched and NIPA-mismatched haploidentical hematopoietic stem cell transplantation for patients with hematological malignancies

Bone Marrow Transplantation volume 56, pages 2723–2731 (2021)Cite this article

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Abstract

The objective of this study was to compare clinical outcomes between noninherited maternal antigen (NIMA)-mismatched and noninherited paternal antigen (NIPA)-mismatched haploidentical hematopoietic stem cell transplantation (haplo-HSCT) among patients with hematological malignancies and perform a subgroup analysis. We retrospectively analyzed 378 patients with hematological malignancies who received haplo-HSCT from NIMA-mismatched (n = 201) and NIPA-mismatched (n = 177) donors between January 2012 and December 2017. The cumulative incidence of 100-d grades II–IV acute graft-versus-host disease (aGVHD) (19.2% vs. 32.8%, P = 0.003) was significantly lower in NIMA mismatch. Multivariate analysis showed that NIMA mismatch was associated with lower incidence of grades II–IV aGVHD and better overall survival (OS) and disease-free survival (DFS). According to the subgroup analysis, the clinical outcomes of older and/or female NIMA mismatches were comparable to those of younger and/or male NIPA mismatches with respect to grades II–IV aGVHD, chronic GVHD (cGVHD), nonrelapse mortality (NRM), relapse, DFS, and OS. In conclusion, this study confirmed the NIMA effect on aGVHD and demonstrated that NIMA mismatch was associated with better survival. In the NIMA mismatch context, donor age and sex did not seem to influence haplo-HSCT, which provides a basis for the selection of sibling donors.

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Fig. 1: Outcomes of patients with malignant disease after haplo-HSCT with NIMA mismatch and NIPA mismatch.
Fig. 2: Subgroup analysis of older NIMA mismatches and younger NIPA mismatches.
Fig. 3: Subgroup analysis of female NIMA mismatches and male NIPA mismatches.
Fig. 4: Subgroup analysis of older female NIMA mismatches and younger male NIPA mismatches.

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Acknowledgements

This work was supported by the National Key Research and Development Program of China (2019YFC0840606) from the Ministry of Science and Technology, the National Natural Science Foundation of China (81900178, 82070189, 81770189, 81621001, and 81530046), the Science and Technology Project of Guangdong Province of China (2016B030230003), and the Project of Health Collaborative Innovation of Guangzhou City (201704020214).

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Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China

    Fei-Fei Tang, Xiang-Yu Zhao, Ming-Rui Huo, Ying-Jun Chang, Wei Han, Yu-Hong Chen, Chen-Hua Yan, Lan-Ping Xu, Xiao-Hui Zhang, Xiao-Jun Huang & Yu Wang

  2. Peking-Tsinghua Center for Life Sciences, Beijing, China

    Xiao-Jun Huang

  3. Collaborative Innovation Center of Hematology, Peking University, Beijing, China

    Xiao-Jun Huang & Yu Wang

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Tang, FF., Zhao, XY., Huo, MR. et al. Comparison of the clinical outcomes between NIMA-mismatched and NIPA-mismatched haploidentical hematopoietic stem cell transplantation for patients with hematological malignancies. Bone Marrow Transplant 56, 2723–2731 (2021). https://doi.org/10.1038/s41409-021-01382-y

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