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Association of HLA-C disparity with graft failure after marrow transplantation from unrelated donors
Author(s): Petersdorf EW, Longton GM, Anasetti C, Mickelson EM, McKinney SK, Smith AG, Martin PJ, Hansen JA
Source: BLOOD    Volume: 89    Issue: 5    Pages: 1818-1823    Published: MAR 1 1997  
Times Cited: 167     References: 46     
Abstract: Disparity for HLA-A or HLA-B antigens increases the risk of marrow graft rejection, but the relevance of HLA-C is unknown because typing methods have not been sufficiently accurate for clinical use. We designed a matched case-control study and employed DNA sequencing methods to evaluate the role of HLA-C disparity in 21 patients who experienced graft failure (cases) following transplantation with unmanipulated marrow from either HLA-A, B serologically matched, DRB1 matched (n = 14) or single locus mismatched (n = 7) unrelated donors. For each case, two patients who successfully engrafted were selected as controls based on similarity for factors known or suspected to influence engraftment. The estimated odds ratio (OR) of graft failure for an HLA-C mismatch relative to match (univariable model) was 5.2 (95% CI, 1.4, 19; P = .01). Serologically undetectable HLA-A or HLA-B allele disparity was also associated with graft failure, The association between HLA-C disparity and graft failure remained significant even after accounting for the contribution of HLA-A and/or HLA-B allele disparity (OR 4.0; 95% CI, 1.1, 15; likelihood ratio test P = .03). These results show that HLA-C functions as a transplantation antigen and that HLA-A and HLA-B allele mismatches are biologically important. Molecular-based methods for pretransplant assessment of class I compatibility should be implemented for the selection of unrelated marrow donors, (C) 1997 by The American Society of Hematology.
Document Type: Article
Language: English
Reprint Address: Petersdorf, EW (reprint author), FRED HUTCHINSON CANC RES CTR, DIV CLIN RES, 1124 COLUMBIA ST, M718, SEATTLE, WA 98104 USA
Addresses:
1. UNIV WASHINGTON, DEPT MED, SEATTLE, WA USA
Publisher: W B SAUNDERS CO, INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399
Subject Category: Hematology
IDS Number: WK477
ISSN: 0006-4971
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