HLA discrepancy between graft and host rather than that graft and first donor impact the second transplant outcome

HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation

Research output: Contribution to journalArticle

Abstract

Second allogeneic hematopoietic stem cell transplantation is a curative treatment option for patients with hematologic malignancies. However, it is unclear whether HLA discrepancy between graft and first donor has an impact on the outcome of second transplantation. We retrospectively analyzed 646 patients receiving second transplantation after an initial HLA mismatched transplantation. With regard to graft-versus-host, the one-allele mismatch (1 mismatch) group (SHR, 1.88; 95%CI: 0.79-4.45; P=0.163) and more than one-allele mismatch group (≥ 2 mismatch) (SHR, 1.84; 95%CI, 0.75-4.51; P=0.182) had higher risks of grade III-IV acute graft-versus-host disease (GvHD) compared to the HLA-matched (0 mismatch) group. In contrast, no difference in risk of acute GvHD was found among the 0, 1, and ≥ 2 mismatch group with respect to graft-versus-first donor. With regard to graft-versus-host, the ≥ 2 mismatch group showed a significantly higher risk of treatment-related mortality (SHR, 1.90; 95%CI, 1.04-3.50; P=0.038) compared to the 0 mismatch group, while the risk of relapse was slightly lower in the ≥ 2 mismatch group (SHR, 068; 95%CI, 0.44-1.06; P=0.086). In contrast, with regard to graft-versus-first donor, there were no significant differences in treatment-related mortality or relapse among the three groups. These findings suggested that HLA discrepancy between graft and host induces transplant-related immunological responses in second transplantation leading to an increase in treatment-related mortality, in contrast, the biological effects of HLA discrepancy between graft and first donor on outcome may be negligible.

Original languageEnglish
Pages (from-to)1055-1061
Number of pages7
JournalHaematologica
Volume104
Issue number5
DOIs
Publication statusPublished - May 1 2019

Fingerprint

Tissue Donors
Transplants
Transplantation
Graft vs Host Disease
Mortality
Alleles
Recurrence
Hematopoietic Stem Cell Transplantation
Hematologic Neoplasms
Therapeutics

ASJC Scopus subject areas

  • Hematology

Cite this

HLA discrepancy between graft and host rather than that graft and first donor impact the second transplant outcome. / HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation.

In: Haematologica, Vol. 104, No. 5, 01.05.2019, p. 1055-1061.

Research output: Contribution to journalArticle

HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation 2019, 'HLA discrepancy between graft and host rather than that graft and first donor impact the second transplant outcome', Haematologica, vol. 104, no. 5, pp. 1055-1061. https://doi.org/10.3324/haematol.2018.204438
HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation. / HLA discrepancy between graft and host rather than that graft and first donor impact the second transplant outcome. In: Haematologica. 2019 ; Vol. 104, No. 5. pp. 1055-1061.
@article{f2c814aa048b4aa486480300e4e53440,
title = "HLA discrepancy between graft and host rather than that graft and first donor impact the second transplant outcome",
abstract = "Second allogeneic hematopoietic stem cell transplantation is a curative treatment option for patients with hematologic malignancies. However, it is unclear whether HLA discrepancy between graft and first donor has an impact on the outcome of second transplantation. We retrospectively analyzed 646 patients receiving second transplantation after an initial HLA mismatched transplantation. With regard to graft-versus-host, the one-allele mismatch (1 mismatch) group (SHR, 1.88; 95{\%}CI: 0.79-4.45; P=0.163) and more than one-allele mismatch group (≥ 2 mismatch) (SHR, 1.84; 95{\%}CI, 0.75-4.51; P=0.182) had higher risks of grade III-IV acute graft-versus-host disease (GvHD) compared to the HLA-matched (0 mismatch) group. In contrast, no difference in risk of acute GvHD was found among the 0, 1, and ≥ 2 mismatch group with respect to graft-versus-first donor. With regard to graft-versus-host, the ≥ 2 mismatch group showed a significantly higher risk of treatment-related mortality (SHR, 1.90; 95{\%}CI, 1.04-3.50; P=0.038) compared to the 0 mismatch group, while the risk of relapse was slightly lower in the ≥ 2 mismatch group (SHR, 068; 95{\%}CI, 0.44-1.06; P=0.086). In contrast, with regard to graft-versus-first donor, there were no significant differences in treatment-related mortality or relapse among the three groups. These findings suggested that HLA discrepancy between graft and host induces transplant-related immunological responses in second transplantation leading to an increase in treatment-related mortality, in contrast, the biological effects of HLA discrepancy between graft and first donor on outcome may be negligible.",
author = "{HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation} and Yoshinobu Maeda and Tomotaka Ugai and Eisei Kondo and Kazuhiro Ikegame and Makoto Murata and Naoyuki Uchida and Toshihiro Miyamoto and Satoshi Takahashi and Kazuteru Ohashi and Hirohisa Nakamae and Takahiro Fukuda and Makoto Onizuka and Tetsuya Eto and Shuichi Ota and Makoto Hirokawa and Tatsuo Ichinohe and Yoshiko Atsuta and Yoshinobu Kanda and Junya Kanda",
year = "2019",
month = "5",
day = "1",
doi = "10.3324/haematol.2018.204438",
language = "English",
volume = "104",
pages = "1055--1061",
journal = "Haematologica",
issn = "0390-6078",
publisher = "Ferrata Storti Foundation",
number = "5",

}

TY - JOUR

T1 - HLA discrepancy between graft and host rather than that graft and first donor impact the second transplant outcome

AU - HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation

AU - Maeda, Yoshinobu

AU - Ugai, Tomotaka

AU - Kondo, Eisei

AU - Ikegame, Kazuhiro

AU - Murata, Makoto

AU - Uchida, Naoyuki

AU - Miyamoto, Toshihiro

AU - Takahashi, Satoshi

AU - Ohashi, Kazuteru

AU - Nakamae, Hirohisa

AU - Fukuda, Takahiro

AU - Onizuka, Makoto

AU - Eto, Tetsuya

AU - Ota, Shuichi

AU - Hirokawa, Makoto

AU - Ichinohe, Tatsuo

AU - Atsuta, Yoshiko

AU - Kanda, Yoshinobu

AU - Kanda, Junya

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Second allogeneic hematopoietic stem cell transplantation is a curative treatment option for patients with hematologic malignancies. However, it is unclear whether HLA discrepancy between graft and first donor has an impact on the outcome of second transplantation. We retrospectively analyzed 646 patients receiving second transplantation after an initial HLA mismatched transplantation. With regard to graft-versus-host, the one-allele mismatch (1 mismatch) group (SHR, 1.88; 95%CI: 0.79-4.45; P=0.163) and more than one-allele mismatch group (≥ 2 mismatch) (SHR, 1.84; 95%CI, 0.75-4.51; P=0.182) had higher risks of grade III-IV acute graft-versus-host disease (GvHD) compared to the HLA-matched (0 mismatch) group. In contrast, no difference in risk of acute GvHD was found among the 0, 1, and ≥ 2 mismatch group with respect to graft-versus-first donor. With regard to graft-versus-host, the ≥ 2 mismatch group showed a significantly higher risk of treatment-related mortality (SHR, 1.90; 95%CI, 1.04-3.50; P=0.038) compared to the 0 mismatch group, while the risk of relapse was slightly lower in the ≥ 2 mismatch group (SHR, 068; 95%CI, 0.44-1.06; P=0.086). In contrast, with regard to graft-versus-first donor, there were no significant differences in treatment-related mortality or relapse among the three groups. These findings suggested that HLA discrepancy between graft and host induces transplant-related immunological responses in second transplantation leading to an increase in treatment-related mortality, in contrast, the biological effects of HLA discrepancy between graft and first donor on outcome may be negligible.

AB - Second allogeneic hematopoietic stem cell transplantation is a curative treatment option for patients with hematologic malignancies. However, it is unclear whether HLA discrepancy between graft and first donor has an impact on the outcome of second transplantation. We retrospectively analyzed 646 patients receiving second transplantation after an initial HLA mismatched transplantation. With regard to graft-versus-host, the one-allele mismatch (1 mismatch) group (SHR, 1.88; 95%CI: 0.79-4.45; P=0.163) and more than one-allele mismatch group (≥ 2 mismatch) (SHR, 1.84; 95%CI, 0.75-4.51; P=0.182) had higher risks of grade III-IV acute graft-versus-host disease (GvHD) compared to the HLA-matched (0 mismatch) group. In contrast, no difference in risk of acute GvHD was found among the 0, 1, and ≥ 2 mismatch group with respect to graft-versus-first donor. With regard to graft-versus-host, the ≥ 2 mismatch group showed a significantly higher risk of treatment-related mortality (SHR, 1.90; 95%CI, 1.04-3.50; P=0.038) compared to the 0 mismatch group, while the risk of relapse was slightly lower in the ≥ 2 mismatch group (SHR, 068; 95%CI, 0.44-1.06; P=0.086). In contrast, with regard to graft-versus-first donor, there were no significant differences in treatment-related mortality or relapse among the three groups. These findings suggested that HLA discrepancy between graft and host induces transplant-related immunological responses in second transplantation leading to an increase in treatment-related mortality, in contrast, the biological effects of HLA discrepancy between graft and first donor on outcome may be negligible.

UR - http://www.scopus.com/inward/record.url?scp=85065469027&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065469027&partnerID=8YFLogxK

U2 - 10.3324/haematol.2018.204438

DO - 10.3324/haematol.2018.204438

M3 - Article

C2 - 30523056

AN - SCOPUS:85065469027

VL - 104

SP - 1055

EP - 1061

JO - Haematologica

JF - Haematologica

SN - 0390-6078

IS - 5

ER -