Role of HLA match on results of hematopoietic stem cell transplantations from unrelated donors in children with acute leukemia and bone marrow failure syndromes

Abstract

BackgroundIn case of the lack of matched family donors (MFD), hematopoietic stem cell transplantation (HSCT) from unrelated donor (UD) is an established procedure for many acquired and congenital disorders of the hematopoietic system, including malignancies and bone marrow failure (BMF) syndromes. ObjectiveThe analysis of the results of HSCT in patients with acute leukemia or BMF syndromes from UDs with respect to human leukocyte antigen (HLA) match. Patients and methodsA total number of 97 of HSCT from UDs performed in single center between 2007 and 2015 in children and adolescents with acute lymphoblastic (ALL) or myeloblastic leukemia (AML) and BMF syndromes were included into this analysis. HLA match between donor and recipient was analyzed at the allele level and classified as 10/10, 9/10 or 8/10. Data were compared to results of 56 MFD-HSCTs. Probability of overall survival (pOS) was given for 3-year and 1-year (as required by JACIE standards) time periods. ResultsThe mean survival for all patients estimated by Kaplan–Meier method was 4.8 years (95%CI=4.1–5.5 years). The 3-year pOS after all UD-HSCT was 0,60±0,05, and with respect to 10/10, 9/10 and 8/10 HLA match: 0,61±0,06; 0,59±0,09 and 0,60±0,22, respectively (ns). In patients with AML, 3-year pOS reached 52%, 60% and 60%, respectively. In patients with ALL, 3-year pOS was 73% and 62% (ns) for 10/10 and 9/10 HLA match, respectively, while for BMF syndromes 86% and 57% (ns), respectively. ConclusionCurrent data suggest that results of mismatched and matched UD-HSCT in children with acute leukemia might be comparable.