PMID- 19535797
OWN - NLM
STAT- MEDLINE
DCOM- 20090930
LR  - 20210206
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Linking)
VI  - 114
IP  - 8
DP  - 2009 Aug 20
TI  - Impact of HLA disparity in the graft-versus-host direction on engraftment in 
      adult patients receiving reduced-intensity cord blood transplantation.
PG  - 1689-95
LID - 10.1182/blood-2008-12-194696 [doi]
AB  - Delayed engraftment or graft failure is one of the major complications after cord 
      blood transplantation (CBT). To investigate factors impacting engraftment, we 
      conducted a retrospective analysis of adult patients who underwent 
      reduced-intensity CBT at our institute, in which preparative regimens mainly 
      consisted of fludarabine, melphalan, and total body irradiation with 
      graft-versus-host (GVH) disease prophylaxis using single calcineurin inhibitors. 
      Among 152 evaluable patients, the cumulative incidence of neutrophil engraftment 
      was 89%. High total nucleated cell and CD34(+) cell dose were associated with the 
      faster speed and higher probability of engraftment. In addition, the degree of 
      human leukocyte antigen (HLA) mismatch in the GVH direction was inversely 
      associated with engraftment kinetics, whereas no statistically significant 
      association was observed with the degree of HLA mismatch in the host-versus-graft 
      direction. Similarly, the number of HLA class I antigens mismatched in the GVH 
      direction, but not in the host-versus-graft direction, showed a negative 
      correlation with engraftment kinetics. HLA disparity did not have significant 
      impact on the development of GVH disease or survival. This result indicates the 
      significant role of HLA disparity in the GVH direction in the successful 
      engraftment, raising the novel mechanism responsible for graft failure in CBT.
FAU - Matsuno, Naofumi
AU  - Matsuno N
AD  - Department of Hematology, Toranomon Hospital, Tokyo, Japan.
FAU - Wake, Atsushi
AU  - Wake A
FAU - Uchida, Naoyuki
AU  - Uchida N
FAU - Ishiwata, Kazuya
AU  - Ishiwata K
FAU - Araoka, Hideki
AU  - Araoka H
FAU - Takagi, Shinsuke
AU  - Takagi S
FAU - Tsuji, Masanori
AU  - Tsuji M
FAU - Yamamoto, Hisashi
AU  - Yamamoto H
FAU - Kato, Daisuke
AU  - Kato D
FAU - Matsuhashi, Yoshiko
AU  - Matsuhashi Y
FAU - Seo, Sachiko
AU  - Seo S
FAU - Masuoka, Kazuhiro
AU  - Masuoka K
FAU - Miyakoshi, Shigesaburo
AU  - Miyakoshi S
FAU - Makino, Shigeyoshi
AU  - Makino S
FAU - Yoneyama, Akiko
AU  - Yoneyama A
FAU - Kanda, Yoshinobu
AU  - Kanda Y
FAU - Taniguchi, Shuichi
AU  - Taniguchi S
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090617
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Female
MH  - Fetal Blood/*transplantation
MH  - Graft Survival
MH  - Graft vs Host Disease/*diagnosis/immunology/mortality/therapy
MH  - HLA Antigens/analysis/immunology
MH  - Hematologic Neoplasms/diagnosis/immunology/therapy
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Transplantation Conditioning/*methods
MH  - Young Adult
EDAT- 2009/06/19 09:00
MHDA- 2009/10/01 06:00
CRDT- 2009/06/19 09:00
PHST- 2009/06/19 09:00 [entrez]
PHST- 2009/06/19 09:00 [pubmed]
PHST- 2009/10/01 06:00 [medline]
AID - S0006-4971(20)37196-2 [pii]
AID - 10.1182/blood-2008-12-194696 [doi]
PST - ppublish
SO  - Blood. 2009 Aug 20;114(8):1689-95. doi: 10.1182/blood-2008-12-194696. Epub 2009 
      Jun 17.