Short-term clinical outcomes after HLA 1-locus mismatched uPBSCT are similar to that after HLA-matched uPBSCT and uBMT.
Shigeo Fuji, Koichi Miyamura, Yoshinobu Kanda, Takahiro Fukuda, Takeshi Kobayashi, Yukiyasu Ozawa, Koji Iwato, Naoyuki Uchida, Tetsuya Eto, Takashi Ashida, Takehiko Mori, Masashi Sawa, Tatsuo Ichinohe, Yoshiko Atsuta, Junya Kanda, HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation
Author Information
Shigeo Fuji: Department of Hematology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-Ku, Osaka, 541-8567, Japan. fujishige1231@gmail.com. ORCID
Koichi Miyamura: Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
Yoshinobu Kanda: Division of Hematology, Saitama Medical Center Jichi Medical University, Saitama, Japan.
Takahiro Fukuda: Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
Takeshi Kobayashi: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Yukiyasu Ozawa: Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
Koji Iwato: Department of Hematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan.
Naoyuki Uchida: Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan.
Tetsuya Eto: Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
Takashi Ashida: Division of Hematology and Rheumatology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osaka, Japan.
Takehiko Mori: Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Masashi Sawa: Department of Hematology and Oncology, Anjo Kosei Hospital, Nagoya, Japan.
Tatsuo Ichinohe: Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
Yoshiko Atsuta: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
Junya Kanda: Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
In Japan, use of unrelated peripheral blood stem cell transplantation (uPBSCT) from HLA-mismatched unrelated donors has recently been approved. We compared outcomes between HLA-matched and 1-locus mismatched uPBSCT, as well as the impact of HLA disparity in uPBSCT and in unrelated bone marrow transplantation (uBMT). In total, 5862 uBMT recipients and 234 uPBSCT recipients were included. In terms of HLA allele disparity, 185 uPBSCT patients (79.1%) had no HLA mismatch, and 49 (20.9%) had 1-locus mismatch; in comparison, 3585 uBMT patients (61.2%) had no HLA mismatch, and 2277 (38.8%) had 1-locus mismatch. The impact of 1-locus mismatch as compared with match in uPBSCT was not significantly higher than in uBMT [hazard ratio (HR) = 1.02 and 1.27 for grade III-IV acute graft-versus-host disease, HR = 0.98 and 1.14 for non-relapse mortality, and HR = 0.87 and 1.06 for overall survival, respectively]. In conclusion, the impact of single-locus mismatch on short-term outcomes was comparable in uPBSCT and uBMT. Larger studies with longer follow-up are needed to assess long-term outcomes.
