PMID- 19924143
OWN - NLM
STAT- MEDLINE
DCOM- 20100127
LR  - 20211020
IS  - 1476-5551 (Electronic)
IS  - 0887-6924 (Linking)
VI  - 24
IP  - 1
DP  - 2010 Jan
TI  - Diverging effects of HLA-DPB1 matching status on outcome following unrelated 
      donor transplantation depending on disease stage and the degree of matching for 
      other HLA alleles.
PG  - 58-65
LID - 10.1038/leu.2009.239 [doi]
AB  - Disease stage and recipient/donor human leukocyte antigen (HLA) matching are 
      important determinants of outcome in transplantation using volunteer-unrelated 
      donors (VUD). Matching for HLA-A, -B, -C, -DRB1, -DQB1 is beneficial, whereas the 
      importance of DPB1 matching is more controversial. The impact of HLA matching 
      status may differ dependent on disease stage. We investigated the outcome 
      according to the degree of HLA matching at 6 loci, in 488 recipients of 
      predominantly T-cell depleted bone marrow VUD transplants for leukaemia. Survival 
      was significantly better in 12/12-matched transplants in those with early 
      leukaemia (5 years: 63 versus 41% in 10/10 matched, P=0.006), but not late stage 
      disease. Conversely, within the HLA-mismatched group (< or =9/10), there was a 
      significant survival advantage to DPB1 mismatching (5 years: 39 versus 21% in 
      DPB1 matched, P=0.008), particularly in late leukaemia (P=0.01), persisting in 
      multivariate analysis (odds ratio 0.478; 95% confidence interval 0.30, 0.75; 
      P=0.001). These novel findings suggest that the best outcome for patients with 
      early leukaemia, with a 10/10-matched donor, is achieved by matching for DPB1. 
      Conversely, our results suggest that in patients receiving an HLA-mismatched 
      graft, the outcome is significantly better if they are also mismatched for DPB1. 
      We recommend validation of these results in independent datasets.
FAU - Shaw, B E
AU  - Shaw BE
AD  - Research Department, Anthony Nolan Research Institute, Royal Free Hospital, Pond 
      Street, Hampstead, London NW3 2QG, UK. bshaw@doctors.org.uk
FAU - Mayor, N P
AU  - Mayor NP
FAU - Russell, N H
AU  - Russell NH
FAU - Apperley, J F
AU  - Apperley JF
FAU - Clark, R E
AU  - Clark RE
FAU - Cornish, J
AU  - Cornish J
FAU - Darbyshire, P
AU  - Darbyshire P
FAU - Ethell, M E
AU  - Ethell ME
FAU - Goldman, J M
AU  - Goldman JM
FAU - Little, A-M
AU  - Little AM
FAU - Mackinnon, S
AU  - Mackinnon S
FAU - Marks, D I
AU  - Marks DI
FAU - Pagliuca, A
AU  - Pagliuca A
FAU - Thomson, K
AU  - Thomson K
FAU - Marsh, S G E
AU  - Marsh SG
FAU - Madrigal, J A
AU  - Madrigal JA
LA  - eng
GR  - MC_G0802523/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20091119
PL  - England
TA  - Leukemia
JT  - Leukemia
JID - 8704895
RN  - 0 (HLA Antigens)
RN  - 0 (HLA-DP Antigens)
RN  - 0 (HLA-DP beta-Chains)
RN  - 0 (HLA-DPB1 antigen)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Alleles
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Graft vs Host Disease/etiology
MH  - HLA Antigens/*genetics
MH  - HLA-DP Antigens/*immunology
MH  - HLA-DP beta-Chains
MH  - *Hematopoietic Stem Cell Transplantation
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Leukemia/immunology/*therapy
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Tissue Donors
EDAT- 2009/11/20 06:00
MHDA- 2010/01/28 06:00
CRDT- 2009/11/20 06:00
PHST- 2009/11/20 06:00 [entrez]
PHST- 2009/11/20 06:00 [pubmed]
PHST- 2010/01/28 06:00 [medline]
AID - leu2009239 [pii]
AID - 10.1038/leu.2009.239 [doi]
PST - ppublish
SO  - Leukemia. 2010 Jan;24(1):58-65. doi: 10.1038/leu.2009.239. Epub 2009 Nov 19.