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Effect of HLA-matching recipients to donor noninherited maternal antigens on outcomes after mismatched umbilical cord blood transplantation for hematologic malignancy.

Publication ,  Journal Article
Rocha, V; Spellman, S; Zhang, M-J; Ruggeri, A; Purtill, D; Brady, C; Baxter-Lowe, LA; Baudoux, E; Bergamaschi, P; Chow, R; Freed, B; Lecchi, L ...
Published in: Biol Blood Marrow Transplant
December 2012

Transplantation-related mortality (TRM) is high after HLA-mismatched umbilical cord blood (UCB) transplantation (UCBT). In utero, exposure to noninherited maternal antigen (NIMA) is recognized by the fetus, which induces T regulator cells to that haplotype. It is plausible that UCBTs in which recipients are matched to donor NIMAs may alleviate some of the excess mortality associated with this treatment. To explore this concept, we used marginal matched-pair Cox regression analysis to compare outcomes in 48 NIMA-matched UCBTs (ie, the NIMA of the donor UCB unit matched to the patient) and in 116 non-NIMA-matched UCBTs. All patients had a hematologic malignancy and received a single UCB unit. Cases and controls were matched on age, disease, disease status, transplantation-conditioning regimen, HLA match, and infused cell dose. TRM was lower after NIMA-matched UCBTs compared with NIMA-mismatched UCBTs (relative risk, 0.48; P = .05; 18% versus 32% at 5 years posttransplantation). Consequently, overall survival was higher after NIMA-matched UCBT. The 5-year probability of overall survival was 55% after NIMA-matched UCBTs versus 38% after NIMA-mismatched UCBTs (P = .04). When faced with the choice of multiple HLA-mismatched UCB units containing adequate cell doses, selecting an NIMA-matched UCB unit may improve survival after mismatched UCBT.

Duke Scholars

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

December 2012

Volume

18

Issue

12

Start / End Page

1890 / 1896

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tissue Donors
  • Survival Rate
  • Male
  • Lymphoma
  • Leukemia
  • Immunology
  • Humans
  • HLA Antigens
  • Fetal Blood
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Rocha, V., Spellman, S., Zhang, M.-J., Ruggeri, A., Purtill, D., Brady, C., … Eurocord-European Blood and Marrow Transplant Group and the Center for International Blood and Marrow Transplant Research, . (2012). Effect of HLA-matching recipients to donor noninherited maternal antigens on outcomes after mismatched umbilical cord blood transplantation for hematologic malignancy. Biol Blood Marrow Transplant, 18(12), 1890–1896. https://doi.org/10.1016/j.bbmt.2012.07.010
Rocha, Vanderson, Stephen Spellman, Mei-Jie Zhang, Annalisa Ruggeri, Duncan Purtill, Colleen Brady, Lee Ann Baxter-Lowe, et al. “Effect of HLA-matching recipients to donor noninherited maternal antigens on outcomes after mismatched umbilical cord blood transplantation for hematologic malignancy.Biol Blood Marrow Transplant 18, no. 12 (December 2012): 1890–96. https://doi.org/10.1016/j.bbmt.2012.07.010.
Rocha V, Spellman S, Zhang M-J, Ruggeri A, Purtill D, Brady C, et al. Effect of HLA-matching recipients to donor noninherited maternal antigens on outcomes after mismatched umbilical cord blood transplantation for hematologic malignancy. Biol Blood Marrow Transplant. 2012 Dec;18(12):1890–6.
Rocha, Vanderson, et al. “Effect of HLA-matching recipients to donor noninherited maternal antigens on outcomes after mismatched umbilical cord blood transplantation for hematologic malignancy.Biol Blood Marrow Transplant, vol. 18, no. 12, Dec. 2012, pp. 1890–96. Pubmed, doi:10.1016/j.bbmt.2012.07.010.
Rocha V, Spellman S, Zhang M-J, Ruggeri A, Purtill D, Brady C, Baxter-Lowe LA, Baudoux E, Bergamaschi P, Chow R, Freed B, Koegler G, Kurtzberg J, Larghero J, Lecchi L, Nagler A, Navarrette C, Prasad V, Pouthier F, Price T, Ratanatharathorn V, van Rood JJ, Horowitz MM, Gluckman E, Eapen M, Eurocord-European Blood and Marrow Transplant Group and the Center for International Blood and Marrow Transplant Research. Effect of HLA-matching recipients to donor noninherited maternal antigens on outcomes after mismatched umbilical cord blood transplantation for hematologic malignancy. Biol Blood Marrow Transplant. 2012 Dec;18(12):1890–1896.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

December 2012

Volume

18

Issue

12

Start / End Page

1890 / 1896

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tissue Donors
  • Survival Rate
  • Male
  • Lymphoma
  • Leukemia
  • Immunology
  • Humans
  • HLA Antigens
  • Fetal Blood