Bone Marrow Transplantation ( IF 4.5 ) Pub Date : 2024-01-18 , DOI: 10.1038/s41409-023-02183-1 Takeshi Sugio 1, 2 , Naoyuki Uchida 3 , Kohta Miyawaki 1 , Yuju Ohno 4 , Tetsuya Eto 5 , Yasuo Mori 1 , Goichi Yoshimoto 1 , Yoshikane Kikushige 1 , Yuya Kunisaki 1 , Shinichi Mizuno 6 , Koji Nagafuji 7 , Hiromi Iwasaki 8 , Tomohiko Kamimura 9 , Ryosuke Ogawa 10 , Toshihiro Miyamoto 11 , Shuichi Taniguchi 3, 5 , Koichi Akashi 1 , Koji Kato 1
The “human leukocyte antigen (HLA) supertype” is a functional classification of HLA alleles, which was defined by structural features and peptide specificities, and has been reportedly associated with the clinical outcomes of viral infections and autoimmune diseases. Although the disparity in each HLA locus was reported to have no clinical significance in single-unit cord blood transplantation (sCBT), the clinical significance of the HLA supertype in sCBT remains unknown. Therefore, we retrospectively analyzed clinical data of 1603 patients who received sCBT in eight institutes in Japan between 2000 and 2017. Each HLA allele was categorized into 19 supertypes, and the prognostic effect of disparities was then assessed. An HLA-B supertype mismatch was identified as a poor prognostic factor (PFS: hazard ratio [HR] = 1.23, p = 0.00044) and was associated with a higher cumulative incidence (CI) of relapse (HR = 1.24, p = 0.013). However, an HLA-B supertype mismatch was not associated with the CI of acute and chronic graft-versus-host-disease. The multivariate analysis for relapse and PFS showed the significance of an HLA-B supertype mismatch independent of allelic mismatches, and other previously reported prognostic factors. HLA-B supertype-matched grafts should be selected in sCBT.
中文翻译:
单单位脐带血移植中HLA超型不匹配的预后影响
“人类白细胞抗原(HLA)超型”是 HLA 等位基因的功能分类,由结构特征和肽特异性定义,据报道与病毒感染和自身免疫性疾病的临床结果相关。尽管据报道每个 HLA 位点的差异在单单位脐带血移植 (sCBT) 中没有临床意义,但 HLA 超型在 sCBT 中的临床意义仍不清楚。因此,我们回顾性分析了2000年至2017年间在日本8个机构接受sCBT的1603名患者的临床数据。每个HLA等位基因被分为19个超型,然后评估差异的预后效果。 HLA-B 超型不匹配被确定为不良预后因素(PFS:风险比 [HR] = 1.23, p = 0.00044),并且与较高的复发累积发生率 (CI) 相关(HR = 1.24, p = 0.013) 。然而,HLA-B 超型不匹配与急性和慢性移植物抗宿主病的 CI 无关。复发和 PFS 的多变量分析显示 HLA-B 超型错配的重要性,独立于等位基因错配和其他先前报道的预后因素。 sCBT 中应选择 HLA-B 超型匹配的移植物。