Impact of HLA-A, B, C allele mismatches on outcome after unrelated blood stem cell transplantation in whites

• Published in: Transplantation Vol. 78; no. 7; pp. 1077 - 1080
• Main Authors: OTTINGER, H. D, FERENCIK, S, BEELEN, D. W, LINDEMANN, M, PECENY, R, ELMAAGACLI, A. H, GROSSE-WILDE, H
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 15-10-2004
• Subjects: Alleles; Biological and medical sciences; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hematopoietic Stem Cell Transplantation; Histocompatibility Testing; HLA-A Antigens - genetics; HLA-B Antigens - genetics; HLA-C Antigens - genetics; Humans; Medical sciences; Multivariate Analysis; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; HLA-System; Prognosis; Major histocompatibility system; HLA-C-Locus; Homograft; Blood; Allele; HLA-A-Locus; Evolution; Graft; Genetics; Histocompatibility; Class I histocompatibility antigen; HLA-B-Locus
• ISSN: 0041-1337; 1534-6080
• DOI: 10.1097/01.TP.0000137791.28140.93

At our institution the selection of unrelated donors for hematopoietic stem cell transplantation (HSCT) relies on low resolution human leukocyte antigen (HLA)-A,B and high resolution HLA-DRB1,DQB1 DNA-based typing. To answer the question of whether routine high resolution HLA-A,B,C typing might improve HSCT outcome, 171 white "HLA-identical" donor/recipient pairs, as stated by our pretransplant tissue typing routine, were retyped for HLA-A,B,C using sequence based typing (SBT). The numbers of HLA-A,B,C allele mismatches detected by SBT were correlated to established clinical endpoints of HSCT outcome. We found 33.9% of the study transplants to be fully HLA-A,B,C matched, whereas 66.1 % exhibited one through four donor/recipient HLA-A,B,C allele mismatches. However, statistical analysis could not demonstrate an impact of the number of HLA-A,B,C allele mismatches on overall survival and other analyzed endpoints. Thus, our series of white donor/recipient pairs does not suggest the routine use of HLA-A,B,C SBT to improve HSCT outcome substantially.