Impact of Allele-Level HLA Mismatch on Outcomes in Recipients of Double Umbilical Cord Blood Transplantation

Claudio G. Brunstein, Effie W. Petersdorf, Todd E. DeFor, Harriet Noreen, Margaret L. MacMillan, Celalettin Ustun, Michael R. Verneris, Jeffrey S. Miller, Bruce R. Blazar, Philip B. McGlave, Daniel J. Weisdorf, John E. Wagner

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38 Scopus citations


The impact of allele-level HLA mismatch is uncertain in recipients of double umbilical cord blood (UCB) transplantation. We report a single-center retrospective study of the clinical effect of using allele-level HLA mismatch HLA-A, -B, -C, -DRB1, and -DQB1 of the 2 UCB units. We studied 342 patients with hematologic malignancy. Donor–recipient pairs were grouped according to the number of matched HLA alleles, with 32 matched at 9-10/10, 202 at 6-8/10, and 108 at 2-5/10 alleles. The incidence of hematopoietic recovery, acute and chronic graft-versus-host disease, and nonrelapse mortality and treatment failure was similar between groups. In an exploratory analysis of 174 patients with acute leukemia, after adjusting for length of first remission and cytogenetic risk group, a 2-5/10 HLA match was associated with lower risk of relapse and treatment failure. These data indicate that a high degree of allele-level HLA mismatch does not adversely affect transplant outcomes and may be associated with reduced relapse risk in patients with acute leukemia.

Original languageEnglish (US)
Pages (from-to)487-492
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Issue number3
StatePublished - Mar 1 2016

Bibliographical note

Publisher Copyright:
© 2016 American Society for Blood and Marrow Transplantation


  • Alternative donor transplant
  • Histocompatibility
  • Umbilical cord blood


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