Nonpermissive HLA-DPB1 disparity is a significant independent risk factor for mortality after unrelated hematopoietic stem cell transplantation

摘要: The importance of donor-recipient human leukocyte antigen (HLA)-DPB1 matching for the clinical outcome unrelated hematopoietic stem cell transplantation (HSCT) is controversial. We have previously described an algorithm nonpermissive HLA-DPB1 disparities involving HLA-DPB1*0901,*1001,*1701,*0301,*1401,*4501, based on T-cell alloreactivity patterns. By revisiting immunogenicity HLA-DPB1*02, a modified was developed and retrospectively tested in 621 HSCTs facilitated through Italian Registry oncohematologic adult patients. proved to be markedly more predictive than original one, with significantly higher Kaplan-Meier probabilities 2-year survival permissive compared transplantations (55% vs 39%, P = .005). This result increased adjusted hazards nonrelapse mortality (hazard ratio [HR] 1.74; confidence interval [CI], 1.19-2.53; .004) but not relapse (HR 1.02; CI, 0.73-1.42; .92). increase overall by disparity similar 10 2.12; 1.23-3.64; .006) 9 allele-matched 2.21; 1.28-3.80; .004), both early-stage advanced-stage disease. These data call current HLA strategies HSCT, suggesting that searches should directed up-front toward identification permissive, or matched donors.