Donor selection in a pediatric stem cell transplantation cohort using PIRCHE and HLA-DPB1 typing.
Adolescent
Adult
Child
Child, Preschool
Donor Selection
Epitopes
/ immunology
Female
Follow-Up Studies
Graft vs Host Disease
/ immunology
HLA-DP beta-Chains
/ immunology
Hematologic Neoplasms
/ immunology
Hematopoietic Stem Cell Transplantation
/ mortality
Histocompatibility Testing
Humans
Infant
Male
Neoplasm Recurrence, Local
/ immunology
Prognosis
Retrospective Studies
Survival Rate
Unrelated Donors
Young Adult
HLA-DPB1
HLA-typing
PIRCHE
donor selection
nonmalignant diseases
pediatric stem cell transplantation
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
11
08
2019
revised:
24
11
2019
accepted:
25
11
2019
pubmed:
19
12
2019
medline:
6
5
2020
entrez:
19
12
2019
Statut:
ppublish
Résumé
New strategies to optimize donor selection for hematopoietic stem cell transplantation (HSCT) have mainly been evaluated in adults, but the disease spectrum requiring HSCT differs significantly in children and has consequences for the risk of complications, such as graft-versus-host disease (GvHD). Here we evaluated whether HLA-DPB1 and Predicted Indirectly ReCognizable HLA-Epitope (PIRCHE) matching can improve donor selection and minimize risks specific for a pediatric cohort undergoing HSCT in Berlin between 2014 and 2016. The percentage of HLA-DPB1-mismatched HSCT in the pediatric cohort was in line with the general distribution among matched unrelated donor HSCT. Nonpermissive HLA-DPB1 mismatches were not associated with a higher incidence of GvHD, but the incidence of relapse was higher in patients undergoing HSCT from HLA-DPB1-matched transplantations. High PIRCHE-I scores were associated with a significantly higher risk for developing GvHD in patients undergoing HSCT from nine of ten matched unrelated donors. This finding persisted after including HLA-DPB1 into the PIRCHE analysis. Implementing PIRCHE typing in the donor selection process for HSCT in children could particularly benefit children with nonmalignant diseases and support further validation of PIRCHE-based donor selection in a larger number of children treated at different sites.
Sections du résumé
BACKGROUND
New strategies to optimize donor selection for hematopoietic stem cell transplantation (HSCT) have mainly been evaluated in adults, but the disease spectrum requiring HSCT differs significantly in children and has consequences for the risk of complications, such as graft-versus-host disease (GvHD).
PROCEDURES
Here we evaluated whether HLA-DPB1 and Predicted Indirectly ReCognizable HLA-Epitope (PIRCHE) matching can improve donor selection and minimize risks specific for a pediatric cohort undergoing HSCT in Berlin between 2014 and 2016.
RESULTS
The percentage of HLA-DPB1-mismatched HSCT in the pediatric cohort was in line with the general distribution among matched unrelated donor HSCT. Nonpermissive HLA-DPB1 mismatches were not associated with a higher incidence of GvHD, but the incidence of relapse was higher in patients undergoing HSCT from HLA-DPB1-matched transplantations. High PIRCHE-I scores were associated with a significantly higher risk for developing GvHD in patients undergoing HSCT from nine of ten matched unrelated donors. This finding persisted after including HLA-DPB1 into the PIRCHE analysis.
CONCLUSIONS
Implementing PIRCHE typing in the donor selection process for HSCT in children could particularly benefit children with nonmalignant diseases and support further validation of PIRCHE-based donor selection in a larger number of children treated at different sites.
Substances chimiques
Epitopes
0
HLA-DP beta-Chains
0
HLA-DPB1 antigen
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e28127Informations de copyright
© 2019 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals, Inc.
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