No effect of HLA-C mismatch after allogeneic hematopoietic stem cell transplantation with unrelated donors and T-cell depletion in patients with hematological malignancies

Clin Transplant. 2017 Aug;31(8). doi: 10.1111/ctr.13012. Epub 2017 Jun 25.

Abstract

HLA-C mismatch in unrelated donor's hematopoietic stem cell transplantation (HSCT) has been associated with poor patient outcome. However, the impact of HLA-C mismatch in the context of HSCT combined with in vivo T-cell depletion remains unclear. We therefore performed a single-center, retrospective analysis of the clinical outcome on patients with hematological malignancies treated with allo-HSCT, who underwent T-cell depletion. The majority of the patients (n=276) received a HLA-A, HLA-B, HLA-DRB1-matched graft that were either also HLA-C matched (n=260), or patients with the permissive HLA-C*03:03/03:04 mismatch (n=16), while the remaining patients (n=95) received a HLA-C-mismatched graft (excluding HLA-C*03:03/03:04 mismatches). We did not observe any significant differences between the HLA-C-matched patients (including the permissive HLA-C*03:03/03:04 mismatch) and the HLA-C-mismatched patients regarding cumulative proportion surviving, graft failure, relapse-free survival, relapse, or acute graft-versus-host disease. Our data suggest that in the context of high dose T lymphocyte-depleting agents, HLA-C matching is not essential for patients with hematological malignancies.

Keywords: HLA mismatch; HLA-C; T-cell depletion; allogeneic stem cell transplantation; graft-versus-host disease.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Female
  • Graft Survival
  • Graft vs Host Disease / immunology
  • HLA-C Antigens / immunology*
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / therapy*
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cell Transplantation / mortality
  • Histocompatibility*
  • Humans
  • Infant
  • Infant, Newborn
  • Lymphocyte Depletion*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Transplantation, Homologous
  • Treatment Outcome
  • Unrelated Donors*
  • Young Adult

Substances

  • HLA-C Antigens