P109 Clinical outcome of hematopoietic stem cell transplantation -HSCT in patients with DP-TCE matched donors and various stem cell sources

Abstract

Aim Attaining an HLA matched HSCT is important in achieving better graft survival. This study focuses on comparing patients with DP-TCE permissive transplants to those with unknown DP-TCE, to understand the impact of DP typing on graft versus host disease (GVHD). The source of stem cells is included in this study to evaluate any impact it may have on clinical outcomes. Methods Patients: We analyzed 110 consecutive patients that underwent HSCT at OU Medical Center from 2014 to 2016. In this cohort, DP typing was available in 15 and DP was unknown in remaining. Clinical observation: Charts were reviewed and GVHD assessment was collected after transplant. Statistic: Fisher exact test. Results Transplants from unrelated donors with 10/10 HLA matched and DP-TCE permissive (N = 10) graft developed GVHD in 60% of cases while transplants from DP-TCE non-permissive (N = 5) graft developed GVHD in 100% of cases. The majority of patients that underwent DP typing were peripheral blood (73%). Prior to DP typing, patients that were 10/10 matched to an unrelated donor showed less GVHD (P value: 0.038) when transplanted with bone marrow (N = 34) versus peripheral blood (N = 32) stem cells. Similar findings were seen in siblings that were 10/10 matched (see table). As expected, cord blood fared better with mismatches, confirming data that mismatched cord blood transplant GVHD was similar to unrelated donor transplants. Conclusions Patients with DP-TCE non-permissive transplant are more likely to develop GVHD compared to patients with DP-TCE permissive transplant. Peripheral blood stem cell transplant patients showed higher levels of GVHD than other cell sources. Matched related donors showed decreased levels of GVHD compared to matched unrelated donors, and cord blood showed lower level of GVHD. DP-TCE testing, however, identified subgroups within the transplanted cohort that fared better if permissive typing was found. The number of cases identified is small, but warrants larger assessment to confirm observations seen. Download : Download high-res image (116KB) Download : Download full-size image