ArticleTransplantation and cellular therapy2026
Post-Transplant Cyclophosphamide Improves Survival in HLA-DPB1 Mismatched Unrelated Donor Allogeneic Transplantation.
Article in Transplantation and cellular therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- HLA matching in contemporary haematopoietic cell transplantation: Recommendations from the EBMT Practice Harmonisation and Guidelines Committee.Bone marrow transplantation · 2026Guideline
- System-level Redesign of an Allogeneic Hematopoietic Cell Transplantation Program Associated With High One-year Survival and Reduced Cost.Transplantation and cellular therapy · 2026Article
- Curative Approach to the Treatment of Beta-Thalassemia and Sickle Cell Disease with Hematopoietic Stem Cell Transplantation.Journal of clinical medicine · 2026Review
- Beyond histocompatibility: human leukocyte antigen as a cross-disciplinary platform for immune recognition and clinical decision-making.Frontiers in immunology · 2026Review
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
HLA-DPB1 mismatching is common in unrelated donor (URD) hematopoietic cell transplantation (HCT) and increases graft-versus-host disease (GVHD) when using methotrexate and tacrolimus (MTX/Tac)-based GVHD prophylaxis. Historically, national and international guidelines recommended prioritizing HLA-DPB1 matching in URD selection. The impact of HLA-DPB1 matching in URD HCT when using post-transplantation cyclophosphamide (PTCy) has been understudied. Our primary endpoint was the association of GVHD-prophylaxis strategy with overall survival (OS) after T cell-replete 12/12 HLA-matched or HLA-DPB1 permissive or non-permissive (NP) mismatch (MM) (defined by the T-cell-epitope groups model) URD HCT. GVHD-free, relapse-free survival (GRFS) was our key secondary endpoint. This was a retrospective cohort study using the Center for International Blood and Marrow Transplant Research (CIBMTR) database. Recipients underwent a first HCT from 2015-2020 for acute leukemia or myelodysplastic syndrome using either HLA-DPB1 NP MM (n = 329), permissive MM (n = 992), or 12/12 HLA-matched (n = 300) URD with PTCy ± mycophenolate mofetil and/or a calcineurin inhibitor, or HLA-DPB1 NP MM (n = 709), permissive MM (n = 2,395), or 12/12 HLA-matched (n = 911) URD with MTX/Tac. HLA-DPB1 NP MM HCT with MTX/Tac was associated with higher treatment-related mortality (TRM) (hazard ratio [HR]: 1.64, 1.08-2.49, P = .019), lower relapse (HR: 0.73, 0.59-0.92, P = .0073), inferior OS (HR: 1.27, 1.03 -1.57, P = .023), and worse GRFS (HR: 1.61, 1.34-1.94, P < .0001) when compared with HLA-DPB1 NP MM HCT with PTCy. Adjusted 1-yr estimates for GRFS were 54% (95% confidence interval [CI]: 49-60%) for PTCy and 40% (CI: 37-44%) for MTX/Tac. For permissive MM URD HCT, MTX/Tac was associated with inferior GRFS (HR 1.54, CI: 1.36-1.76, P < .0001) when compared with PTCy. When using PTCy, there were no significant differences in the above outcomes for HLA-DPB1 NP MM, HLA-DPB1 permissive MM, or 12/12 HLA-matched URD HCT. PTCy should be the preferred GVHD prophylaxis strategy for HLA-DPB1 MM URD HCT. Furthermore, within PTCy platforms, survival is comparable across HLA-DPB1 match and thus NP mismatching at HLA-DPB1 should not be avoided in URD selection when using PTCy.
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