Matching at Human Leukocyte Antigen-C Improved the Outcomes after Double Umbilical Cord Blood Transplantation for Recipients of Two to Four of Six Human Leukocyte Antigen–Matched Grafts

Claudio G. Brunstein, Corey S. Cutler, Todd E. DeFor, Haesook Kim, Nelli Bejanyan, Alfred Garfall, Michael R. Verneris, Yi Bin Chen, Erica D. Warlick, Thomas Spitzer, Jeffrey S. Miller, Joseph H. Antin, Daniel J. Weisdorf, Robert Soiffer, John E. Wagner, Karen K. Ballen

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

We studied the effect of HLA-C matching in 515 patients after double umbilical cord blood (UCB) transplantation. After HLA matching HLA-A, -B, and -DRB1 at the allele level, we scored patients according to number of donor-recipient HLA-C matches at 4 possible loci: 2 from each donor unit, at the allele level. Given a direct interaction between HLA-A, -B, and -DRB1 matching and HLA-C score, we analyzed HLA-C matching in those receiving at least 1 2/6 to 4/6 HLA–matched unit (n = 389) versus those receiving only 5/6 or 6/6–matched units (n = 126). In those with at least 1 2/6 to 4/6 HLA–matched unit, a better HLA-C matching score was associated with significantly lower risk of death of any cause and nonrelapse mortality and better disease-free survival. There was no association with the risk of relapse, acute and chronic graft-versus-host disease, and hematopoietic recovery. In contrast, among patients receiving only allele-level 5/6 or 6/6 HLA–matched UCB units, HLA-C match had no demonstrable effect on any outcome. For patients receiving at least 1 allele-level 2/6 to 4/6 HLA–matched UCB unit, matching at HLA-C reduces nonrelapse mortality and improves survival.

Original languageEnglish (US)
Pages (from-to)126-133
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • Alternative donor transplantation
  • Double umbilical cord blood
  • Human leukocyte antigen

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