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Impact of patient: donor HLA disparity on reduced-intensity-conditioned allogeneic stem cell transplants from HLA mismatched unrelated donors for AML: from the ALWP of the EBMT

J. Loke, M. Labopin, C. Craddock, D. Niederwieser, J. Cornelissen, B. Afansayev, P. Jindra, J. Maertens, D. Blaise, K. Boriskina, M. Gramatzki, A. Ganser, B. Savani, M. Mohty, A. Nagler

. 2021 ; 56 (3) : 614-621. [pub] 20201002

Language English Country Great Britain

Document type Journal Article, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc21025992

Grant support
Cancer Research UK - United Kingdom

E-resources Online Full text

NLK Free Medical Journals from 1997 to 1 year ago
Freely Accessible Science Journals from 1997 to 1 year ago
ProQuest Central from 2000-01-01 to 1 year ago
Open Access Digital Library from 1997-01-01
Health & Medicine (ProQuest) from 2000-01-01 to 1 year ago

Links

PubMed 33009514
DOI 10.1038/s41409-020-01072-1
Knihovny.cz E-resources

Patients with acute myeloid leukaemia (AML) who lack a matched sibling or unrelated donor commonly undergo transplantation from a donor matched at 9/10 HLA-A, -B, -C, -DRB1, -DQB1 alleles, and it is unclear if a specific locus mismatch is preferable to any other. We therefore studied 937 patients with AML in complete remission transplanted using a reduced intensity conditioning regimen from an unrelated donor mismatched at a single allele. In a multivariate analysis, patient age, adverse karyotype and patient cytomegalovirus (CMV) seropositivity were correlated with decreased leukaemia free survival (LFS) and overall survival (OS). There was no significant difference in LFS or OS between patients transplanted from donors mismatched at HLA-A, -B, -C or -DRB1 in comparison to a HLA-DQB1 mismatched transplant. In a multivariate analysis, patients transplanted with a HLA-A mismatched donor had higher rates of acute graft-versus-host disease (GVHD) and non-relapse mortality (NRM) than patients transplanted with a HLA-DQB1 mismatched donor. Patient CMV seropositivity was associated with an increase in NRM and acute GVHD and reduced LFS and OS, regardless of donor CMV status. For CMV seropositive patients lacking a fully matched donor, alternative GVHD and CMV prophylaxis strategies should be considered.

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