Combined impact of HLA-allele matching and the CD34-positive cell dose on optimal unit selection for single-unit cord blood transplantation in adults. Issue 11 (19th September 2021)

• Record Type: Journal Article
• Authors: Yabe, Toshio; Satake, Masahiro; Odajima, Takeshi; Watanabe-Okochi, Naoko; Azuma, Fumihiro; Kashiwase, Koichi; Matsumoto, Kayoko; Orihara, Takeshi; Yabe, Hiromasa; Kato, Shunichi; Kato, Koji; Kai, Shunro; Mori, Tetsuo; Morishima, Satoko; Takanashi, Minoko; Nakajima, Kazunori; Murata, Makoto; Morishima, Yasuo
• Is Part Of: Leukemia & lymphoma. Volume 62:Issue 11(2021)
• Page Start: 2737
• Page End: 2746
• Publication Date: 2021-09-19
• Subjects: Cord blood transplantation -- HLA-allele matching -- CD34+ cell dose -- total nucleated cells -- HLA-DPB1 -- UCB unit selection; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2021.1929958
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: The combined effects of HLA-allele matching at six-loci (HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1) and CD34 + cell dose on clinical outcomes were analyzed in 1, 226 adult cases with single-unit unrelated cord blood transplantation. In the six-loci analysis, low HLA-allele matches did not significantly increase the overall mortality compared to higher matches, whereas in the five-loci analysis excluding HLA-DPB1, they caused a higher overall mortality (HR 1.42, p = .002), possibly due to the graft-versus-leukemia effect of HLA-DPB1 mismatches. A lower CD34 + cell dose (<.50 × 10 5 /kg) resulted in higher mortality and lower engraftment; these inferior outcomes were offset by high HLA-allele matches (7-10/10 match), while the inferior outcomes of low HLA-allele matches were improved by increasing the CD34 + cell dose. Consideration of the combined effects of the CD34 + cell dose and HLA matching may expand the options for transplantable units when HLA matching or the CD34 + cell dose is inadequate.