HLA-matched sibling transplantation for severe aplastic anemia: impact of HLA DR15 antigen status on engraftment, graft-versus-host disease, and overall survival.

Publication Type:

Journal Article

Source:

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, Volume 18, Issue 9, p.1401-6 (2012)

Keywords:

2012, Adolescent, Adult, Anemia, Aplastic, Bone Marrow Transplantation, Center-Authored Paper, Clinical Research Division, Collaborative Data Services Core Facility, Female, Graft vs Host Disease, Histocompatibility Testing, HLA-DR Serological Subtypes, Humans, Longitudinal Studies, Male, Middle Aged, Multivariate Analysis, Shared Resources, Siblings, Survival Rate, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome

Abstract:

The HLA class II DRB1 antigen DR15 (common alleles *1501, *1502) is an important marker in the pathobiology of severe aplastic anemia (SAA). We studied 1204 recipients of HLA-matched sibling bone marrow transplantation for SAA to determine whether HLA DR15 status (as determined by allele-level typing) affected hematopoietic recovery, graft-versus-host disease (GVHD), or overall survival (OS). In multivariate analysis, secondary graft failure rate at 2 years was lower in patients who were HLA DR15+ (hazard ratio = 0.46, P = .01). However, neutrophil recovery at day -28, platelet recovery at day -100, acute GVHD, chronic GVHD, and overall mortality were independent of DR15 status. The 5-year probabilities of OS, after adjusting for age, race, performance score, transplant-conditioning regimen, and year of transplantation, were 78% and 81% for patients who were HLA DR15+ and HLA DR15-, respectively (P = .35). In conclusion, DR15 status is associated with secondary graft failure after HLA-matched sibling bone marrow transplantation for SAA but has no significant impact on survival.