ArticleBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation2015
HLA Mismatch Is Associated with Worse Outcomes after Unrelated Donor Reduced-Intensity Conditioning Hematopoietic Cell Transplantation: An Analysis from the Center for International Blood and Marrow Transplant Research.
Article in Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Outcomes with mismatched unrelated donor allogeneic hematopoietic stem cell transplantation in adults: A systematic review and meta-analysis.Frontiers in oncology · 2022Pooled it
- Guideline
- Clinical implications of HLA locus mismatching in unrelated donor hematopoietic cell transplantation: a meta-analysis.Oncotarget · 2017Pooled it
- Posttransplant cyclophosphamide as GVHD prophylaxis in patients receiving mismatched unrelated HCT: the PHYLOS trial.Blood advances · 2025Trial
- Posttransplant cyclophosphamide as GVHD prophylaxis for peripheral blood stem cell HLA-mismatched unrelated donor transplant.Blood advances · 2021Trial
- Trial
- Trial
- Survival signal REG3α prevents crypt apoptosis to control acute gastrointestinal graft-versus-host disease.The Journal of clinical investigation · 2018Trial
- Recipient single nucleotide polymorphisms in Paneth cell antimicrobial peptide genes and acute graft-versus-host disease: analysis of BMT CTN-0201 and -0901 samples.British journal of haematology · 2018Trial
- Bortezomib-based immunosuppression after reduced-intensity conditioning hematopoietic stem cell transplantation: randomized phase II results.Haematologica · 2018Trial
- Post-transplant cyclophosphamide improves survival compared to antithymocyte globulin in HLA-mismatched unrelated donor stem cell transplantation.Haematologica · 2026Article
- Outcomes of haploidentical vs mismatched unrelated donor HCT with posttransplant cyclophosphamide prophylaxis.Blood advances · 2025Article
- Test Statistics and Statistical Inference for Data With Informative Cluster Sizes.Biometrical journal. Biometrische Zeitschrift · 2025Article
- Competing risks regression for clustered data with covariate-dependent censoring.Communications in statistics: theory and methods · 2025Article
- Optimizing Access to Unrelated Donors in Canada: Re-Examining the Importance of Donor Factors on Outcomes Following Hematopoietic Cell Transplantation.Current oncology (Toronto, Ont.) · 2024Review
- Improved GRFS after posttransplant cyclophosphamide-based vs ATG-based HLA-mismatched unrelated donor transplant.Blood advances · 2022Article
- A calibrated Bayesian method for the stratified proportional hazards model with missing covariates.Lifetime data analysis · 2022Article
- Biomarkers of immune tolerance in kidney transplantation: an overview.Pediatric nephrology (Berlin, Germany) · 2022Review
- Distributions of the HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 alleles and haplotype frequencies of 1763 stem cell donors in the Colombian Bone Marrow Registry typed by next-generation sequencing.Frontiers in immunology · 2022Article
- Impact of patient: donor HLA disparity on reduced-intensity-conditioned allogeneic stem cell transplants from HLA mismatched unrelated donors for AML: from the ALWP of the EBMT.Bone marrow transplantation · 2021Article
Corrections and comments
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Authors and funding
14 authors at 10 institutions in 2 countries.
Funding
Abstract
Over the past 2 decades, reduced-intensity conditioning allogeneic hematopoietic cell transplantation (RIC HCT) has increased substantially. Many patients do not have fully HLA-matched donors, and the impact of HLA mismatch on RIC HCT has not been examined in large cohorts. We analyzed 2588 recipients of 8/8 HLA-high resolution matched (n = 2025) or single-locus mismatched (n = 563) unrelated donor (URD) RIC HCT from 1999 to 2011. Overall survival (OS) was the primary outcome. Secondary endpoints included treatment-related mortality (TRM), relapse, disease-free survival (DFS), and acute/chronic graft-versus-host disease (GVHD). Adjusted 1- and 3-year OS was better in 8/8- versus 7/8-matched recipients (54.7% versus 48.8%, P = .01, and 37.4% versus 30.9%, P = .005, respectively). In multivariate models 7/8 URD RIC HCT recipients had more grades II to IV acute GVHD (RR = 1.29, P = .0034), higher TRM (RR = 1.52, P < .0001), and lower DFS (RR = 1.12, P = .0015) and OS (RR = 1.25, P = .0001), with no difference in relapse or chronic GVHD. In subgroup analysis, inferior transplant outcomes were noted regardless of the HLA allele mismatched. Previously reported permissive mismatches at HLA-C (C*03:03/C*03:04) and HLA-DP1 (based on T cell-epitope matching) were not associated with better outcomes. Although feasible, single-locus mismatch in RIC URD HCT is associated with inferior outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.