TITLE

Impact of HLA matching on outcome of hematopoietic stem cell transplantation in children with inherited diseases: a single-center comparative analysis of genoidentical, haploidentical or unrelated donors

AUTHOR(S)
Caillat-Zucman, S.; Le Deist, F.; Haddad, E.; Gannaǵe, M.; Cortivo, L. Dal; Jabado, N.; Hacein-Bey-Abina, S.; Blanche, S.; Casanova, J.-L.; Fischer, A.; Cavazzana-Calvo, M.
PUB. DATE
June 2004
SOURCE
Bone Marrow Transplantation;Jun2004, Vol. 33 Issue 11, p1089
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Hematological inherited diseases can be cured by hematopoietic stem cell transplantation (HSCT) from an human leukocyte antigen (HLA)-identical sibling donor (MSD), but the outcome of unrelated donors (URD) or haploidentical donors (HMD) has been a cause of concern. In all, 94 children affected with inherited diseases underwent HSCT at a single center using MSD (group A, n = 31), URD (group B, n = 23) or HMD (group C, n = 40). There was no difference in the rate of engraftment or in the incidence of grades III—IV acute graft-versus-host disease (GVHD) between the groups. Survival rate was 80.6% in group A, 62.5% in group B and 47.5% in group C (P = 0.023). In group B, survival rate was 73.7% in the subgroup with zero or one class I mismatch, and 25% in the subgroup with two or more class I mismatches (P = 0.04). In group C, survival rate was 83.3% in the 9/10-identical subgroup, 64.3% in the seven or 8/10 subgroup, and 25% in the five or 6/10 subgroup (P = 0.0007). Thus, engraftment, incidence of GVHD and survival are similar in recipients of grafts from MSD, URD with 0–1 class I-mismatch, or HMD with at least 7/10 HLA matches. The low success of HSCT using more disparate donors suggests reserving them for patients with very poor prognosis.
ACCESSION #
13176550

 

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