PMID- 37741003
OWN - NLM
STAT- MEDLINE
DCOM- 20231124
LR  - 20231124
IS  - 1898-4002 (Electronic)
IS  - 1896-1126 (Linking)
VI  - 68
IP  - 2
DP  - 2023 Sep
TI  - Alternative donor strategy in unrelated hematopoietic stem cell transplantation - 
      outcome with mismatched donors.
PG  - 332-340
LID - S1896-1126(23)00030-5 [pii]
LID - 10.1016/j.advms.2023.09.003 [doi]
AB  - PURPOSE: This study retrospectively investigated the association between the 
      level of human leukocyte antigen (HLA) mismatches (MMs), direction of disparities 
      and differences at particular HLA locus on clinical outcomes of hematopoietic 
      stem cell transplantation (HSCT). Investigated outcomes were overall survival 
      (OS) and disease-free survival (DFS), graft-versus-host disease (GvHD), relapse 
      and non-relapse mortality (NRM). PATIENTS AND METHODS: Study cohort included 108 
      adult patients transplanted between 2011 and 2021 and their 9/10 mismatched 
      unrelated donors (MMUD). All individuals were typed for HLA-A, -B, -C, -DRB1, 
      -DQB1 and -DPB1 loci using Polymerase Chain Reaction-Sequence Specific Primers, 
      PCR-Sequence Based Typing and Next-Generation Sequencing. All statistical 
      analyses were done in the MedCalc software, version 19.2.6. RESULTS: Patients 
      with MMs at HLA-B locus demonstrated worse OS (P ​= ​0.0440, HR ​= ​2.00, 
      n ​= ​20). Absence of HLA-DRB5 was associated with a higher incidence of GvHD 
      (P ​= ​0.0112, HR ​= ​1.93, n ​= ​67). A lower incidence of GvHD was observed in 
      patients with HLA class II MMs compared to patients with HLA class I MMs 
      (P ​= ​0.0166, HR ​= ​1.94, n ​= ​29). Finally, analysis of PIRCHE score (PS) 
      impact revealed that patients with HLA class II PS ​> ​10 in GvH direction showed 
      higher incidence of GvHD compared to patients with HLA class II PS ​< ​10 
      (P ​= ​0.0073, HR ​= ​2.01, n ​= ​55). CONCLUSION: Obtained results undisputedly 
      indicate the necessity to further investigate this matter on a larger patient 
      group, with focus on specific HLA alleles to define precisely priority criteria 
      for selecting the best donor for all patients, thus improving the outcome of HSCT 
      with an MMUD.
CI  - Copyright (c) 2023 Medical University of Bialystok. Published by Elsevier B.V. All 
      rights reserved.
FAU - Grubic, Zorana
AU  - Grubic Z
AD  - Tissue Typing Centre, Clinical Department for Transfusion Medicine and 
      Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia. 
      Electronic address: zgrubic@kbc-zagreb.hr.
FAU - Maskalan, Marija
AU  - Maskalan M
AD  - Tissue Typing Centre, Clinical Department for Transfusion Medicine and 
      Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia.
FAU - Burek Kamenaric, Marija
AU  - Burek Kamenaric M
AD  - Tissue Typing Centre, Clinical Department for Transfusion Medicine and 
      Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia.
FAU - Desnica, Lana
AU  - Desnica L
AD  - Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, 
      Zagreb, Croatia.
FAU - Mikulic, Mirta
AU  - Mikulic M
AD  - Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, 
      Zagreb, Croatia.
FAU - Stingl Jankovic, Katarina
AU  - Stingl Jankovic K
AD  - Tissue Typing Centre, Clinical Department for Transfusion Medicine and 
      Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia.
FAU - Durakovic, Nadira
AU  - Durakovic N
AD  - Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, 
      Zagreb, Croatia.
FAU - Serventi Seiwerth, Ranka
AU  - Serventi Seiwerth R
AD  - Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, 
      Zagreb, Croatia.
FAU - Vrhovac, Radovan
AU  - Vrhovac R
AD  - Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, 
      Zagreb, Croatia.
FAU - Zunec, Renata
AU  - Zunec R
AD  - Tissue Typing Centre, Clinical Department for Transfusion Medicine and 
      Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia.
LA  - eng
PT  - Journal Article
DEP - 20230922
PL  - Netherlands
TA  - Adv Med Sci
JT  - Advances in medical sciences
JID - 101276222
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Retrospective Studies
MH  - Histocompatibility Testing
MH  - *Hematopoietic Stem Cell Transplantation
MH  - HLA Antigens/genetics
MH  - *Graft vs Host Disease/etiology
OTO - NOTNLM
OT  - HLA alleles
OT  - HLA supertypes
OT  - HSCT
OT  - Mismatch
OT  - PIRCHE
COIS- Declaration of competing interest The authors declare no conflict of interests.
EDAT- 2023/09/24 00:42
MHDA- 2023/11/24 06:42
CRDT- 2023/09/23 18:01
PHST- 2022/12/14 00:00 [received]
PHST- 2023/04/06 00:00 [revised]
PHST- 2023/09/06 00:00 [accepted]
PHST- 2023/11/24 06:42 [medline]
PHST- 2023/09/24 00:42 [pubmed]
PHST- 2023/09/23 18:01 [entrez]
AID - S1896-1126(23)00030-5 [pii]
AID - 10.1016/j.advms.2023.09.003 [doi]
PST - ppublish
SO  - Adv Med Sci. 2023 Sep;68(2):332-340. doi: 10.1016/j.advms.2023.09.003. Epub 2023 
      Sep 22.