PMID- 33273656
OWN - NLM
STAT- MEDLINE
DCOM- 20210316
LR  - 20210316
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 10
IP  - 1
DP  - 2020 Dec 3
TI  - Impact of HLA class I allele-level mismatch on viral infection within 100 days 
      after cord blood transplantation.
PG  - 21150
LID - 10.1038/s41598-020-78259-5 [doi]
LID - 21150
AB  - Viral infection is more frequently reported in cord blood transplantation (CBT) 
      than in transplantation of other stem cell sources, but its precise mechanism 
      related to antiviral host defenses has not been elucidated yet. To evaluate the 
      effect of human leukocyte antigen (HLA) class I allele-level incompatibility on 
      viral infection in CBT, we conducted a single-center retrospective study. Total 
      94 patients were included, and viral infections were detected in 32 patients 
      (34%) within 100 days after CBT. HLA-C mismatches in graft-versus-host direction 
      showed a significantly higher incidence of viral infection (hazard ratio (HR), 
      3.67; p = 0.01), while mismatches in HLA-A, -B, or -DRB1 were not significant. 
      Overall HLA class I mismatch was also a significant risk factor and the predictor 
      of post-CBT viral infection (>/= 3 mismatches, HR 2.38, p = 0.02), probably due to 
      the insufficient cytotoxic T cell recognition and dendritic cell priming. 
      Patients with viral infection had significantly worse overall survival (52.7% vs. 
      72.1%; p = 0.02), and higher non-relapse mortality (29.3% vs. 9.8%; p = 0.01) at 
      5 years. Our findings suggest that appropriate graft selection as well as 
      prophylaxis and early intervention for viral infection in such high-risk patients 
      with >/= 3 HLA class I allele-level mismatches, including HLA-C, may improve CBT 
      outcomes.
FAU - Iemura, Tomoki
AU  - Iemura T
AD  - Department of Hematology and Oncology, Kyoto University, 54, Shogoin 
      Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
FAU - Arai, Yasuyuki
AU  - Arai Y
AD  - Department of Hematology and Oncology, Kyoto University, 54, Shogoin 
      Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. ysykrai@kuhp.kyoto-u.ac.jp.
AD  - Department of Clinical Laboratory Medicine, Graduate School of Medicine, Kyoto 
      University, 54, Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. 
      ysykrai@kuhp.kyoto-u.ac.jp.
FAU - Kanda, Junya
AU  - Kanda J
AD  - Department of Hematology and Oncology, Kyoto University, 54, Shogoin 
      Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
FAU - Kitawaki, Toshio
AU  - Kitawaki T
AD  - Department of Hematology and Oncology, Kyoto University, 54, Shogoin 
      Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
FAU - Hishizawa, Masakatsu
AU  - Hishizawa M
AD  - Department of Hematology and Oncology, Kyoto University, 54, Shogoin 
      Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
FAU - Kondo, Tadakazu
AU  - Kondo T
AD  - Department of Hematology and Oncology, Kyoto University, 54, Shogoin 
      Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
FAU - Yamashita, Kouhei
AU  - Yamashita K
AD  - Department of Hematology and Oncology, Kyoto University, 54, Shogoin 
      Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
FAU - Takaori-Kondo, Akifumi
AU  - Takaori-Kondo A
AD  - Department of Hematology and Oncology, Kyoto University, 54, Shogoin 
      Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201203
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Histocompatibility Antigens Class I)
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Alleles
MH  - Cord Blood Stem Cell Transplantation/*adverse effects
MH  - Female
MH  - Histocompatibility Antigens Class I/*genetics
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Recurrence
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Virus Diseases/epidemiology/*etiology/*genetics/mortality
MH  - Young Adult
PMC - PMC7713055
COIS- The authors declare no competing interests.
EDAT- 2020/12/05 06:00
MHDA- 2021/03/17 06:00
PMCR- 2020/12/03
CRDT- 2020/12/04 05:44
PHST- 2020/06/15 00:00 [received]
PHST- 2020/11/20 00:00 [accepted]
PHST- 2020/12/04 05:44 [entrez]
PHST- 2020/12/05 06:00 [pubmed]
PHST- 2021/03/17 06:00 [medline]
PHST- 2020/12/03 00:00 [pmc-release]
AID - 10.1038/s41598-020-78259-5 [pii]
AID - 78259 [pii]
AID - 10.1038/s41598-020-78259-5 [doi]
PST - epublish
SO  - Sci Rep. 2020 Dec 3;10(1):21150. doi: 10.1038/s41598-020-78259-5.