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Blood, 1 May 2007, Vol. 109, No. 9, pp. 4064-4070. Prepublished online as a Blood First Edition Paper on January 3, 2007; DOI 10.1182/blood-2006-06-032193. This Article Full Text (PDF) All Versions of this Article: blood-2006-06-032193v1 109/9/4064    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wade, J. A. Articles by Kollman, C. Search for Related Content PubMed PubMed Citation Articles by Wade, J. A. Articles by Kollman, C. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted June 28, 2006 Accepted December 23, 2006 HLA mismatching within or outside of cross reactive groups (CREG) is associated with similar outcomes after unrelated hematopoietic stem cell transplant Judith A. Wade, Carolyn Katovich Hurley, Steven K. Takemoto, John Thompson, Stella M. Davies, Thomas C. Fuller, Glenn Rodey, Dennis L. Confer, Harriet Noreen, Michael Haagenson, Fangyu Kan, John Klein, Mary Eapen, Stephen Spellman*, and Craig Kollman Department of Surgery, University of Toronto, Toronto, Canada Department of Oncology, Georgetown University, Washington, DC, United States Department of Internal Medicine, St. Louis University, St. Louis, MO, United States Department of Medicine, University of Kentucky, Lexington, KY, United States Department of Hematology/Oncology, Cincinatti Childrens Hospital Medical Center, Cincinnati, OH, United States Department of Pathology, University of Utah, Salt Lake City, UT, United States Department of Pathology, Baylor College of Medicine, Houston, TX, United States National Marrow Donor Program, Minneapolis, MN, United States Immunology Laboratory, University of Minnesota Medical Center, Fairview, Minneapolis, MN, United States Center for International Blood and Marrow Transplantation Research, Minneapolis, MN, United States Center for International Blood and Marrow Transplantation Research, Milwaukee, WI, United States Jaeb Center for Health Research, Tampa, FL, United States * Corresponding author; email: sspellma{at}nmdp.org. The National Marrow Donor Program® maintains a registry of volunteer donors for patients in need of a hematopoietic stem cell transplant. Strategies for selecting a partially HLA-mismatched donor vary when a full match cannot be identified. Some transplant centers limit the selection of mismatched donors to those sharing mismatched antigens within HLA-A, -B cross reactive groups (CREG). To assess whether an HLA mismatch within a CREG group ("minor") may result in better outcome than a mismatch outside CREG groups ("major"), we analyzed validated outcomes data from 2709 bone marrow and peripheral blood stem cell transplants. 396 pairs (15%) were HLA-DRB1 allele matched but had an antigen-level mismatch at HLA-A or -B. Univariate and multivariate analyses of engraftment, graft-versus-host disease and survival showed that outcome is not significantly different between "minor" and "major" mismatches (p=0.47 from the log-rank test for Kaplan-Meier survival). However, HLA-A, -B, -DRB1 allele matched cases had significantly better outcome than mismatched cases (p<0.0001). For patients without an HLA match, the selection of a CREG compatible donor as tested does not improve outcome CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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