The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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HLA Mismatch Allogeneic Blood and Marrow Transplantation

HLA 불일치 동종조혈모세포이식

  • Kim, Hee-Je (Division of Hematology, Catholic BMT Center, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • 김희제 (가톨릭대학교 서울성모병원, 가톨릭조혈모세포이식센터, 혈액내과)
  • Published : 2014.01.01
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Abstract

A full haplotype mismatch or mismatched unrelated donor transplantation nowadays are well being focused on, as main alternative donor tools for acute leukemia patients in desperate need of allogeneic blood and marrow transplantation (BMT), the ability to overcome various posttransplant complications by adopting the T-cell replete technique in reality. Increasing numbers of allogeneic BMT in good clinical status are largely because it's the best post-remission therapy especially for many patients with acute leukemias. Due to the problems of unavailable donors at appropriate clinical condition and the process of long duration of donor searching step with relatively much higher cost, some of physicians have indulged in haploidentical BMT rather than mismatched unrelated BMT. Both myeloablative and reduced intensity conditioning regimens for mismatched BMT with T-cell replete or T-cell depletion method have been exploited worldwide. Most of all, Asian countries have experienced lower rates of severe acute and chronic GvHD, graft failure, and impressively low transplant-related mortality with longer follow-up duration. Also, we need many future trials to compare outcomes between these two transplant modalities with cord blood transplant in various diseased patient populations.

Keywords

References

  1. Thomas ED, Buckner CD, Banaji M, et al. One hundred patients with acute leukemia treated by chemotherapy, total body irradiation, and allogeneic marrow transplantation. Blood 1977;49:511-533.
  2. Buckner CD, Epstein RB, Rudolph RH, Clift RA, Storb R, Thomas ED. Allogeneic marrow engraftment following whole body irradiation in a patient with leukemia. Blood 1970;35:741-750.
  3. Thomas ED, Storb R, Clift RA, et al. Bone-marrow transplantation (second of two parts). N Engl J Med 1975;292:895-902. https://doi.org/10.1056/NEJM197504242921706
  4. Ciceri F, Labopin M, Aversa F, et al. A survey of fully haploidentical hematopoietic stem cell transplantation in adults with high-risk acute leukemia: a risk factor analysis of outcomes for patients in remission at transplantation. Blood 2008;112:3574-3581. https://doi.org/10.1182/blood-2008-02-140095
  5. Cutler C, Ballen KK. Improving outcomes in umbilical cord blood transplantation: state of the art. Blood Rev 2012;26:241-246. https://doi.org/10.1016/j.blre.2012.08.001
  6. Arcese W, Mangione I, Picardi A. Algorithm for donor selection in 2011. Curr Opin Hematol 2011;18:401-407. https://doi.org/10.1097/MOH.0b013e32834ba838
  7. Tiercy JM. Unrelated hematopoietic stem cell donor matching probability and search algorithm. Bone Marrow Res 2012;2012:695018.
  8. Ballen KK, Koreth J, Chen YB, Dey BR, Spitzer TR. Selection of optimal alternative graft source: mismatched unrelated donor, umbilical cord blood, or haploidentical transplant. Blood 2012;119:1972-1980. https://doi.org/10.1182/blood-2011-11-354563
  9. Lown RN, Shaw BE. Beating the odds: factors implicated in the speed and availability of unrelated haematopoietic cell donor provision. Bone Marrow Transplant 2013;48:210-219. https://doi.org/10.1038/bmt.2012.54
  10. Shim JS, Cho B, Kim M, et al. Early apoptosis in CD34+ cells as a potential heterogeneity in quality of cryopreserved umbilical cord blood. Br J Haematol 2006;135:210-213. https://doi.org/10.1111/j.1365-2141.2006.06270.x
  11. Lv M, Huang XJ. Allogeneic hematopoietic stem cell transplantation in China: where we are and where to go. J Hematol Oncol 2012;5:10. https://doi.org/10.1186/1756-8722-5-10
  12. Petersdorf EW, Malkki M. Human leukocyte antigen matching in unrelated donor hematopoietic cell transplantation. Semin Hematol 2005;42:76-84. https://doi.org/10.1053/j.seminhematol.2005.01.009
  13. Kawase T, Morishima Y, Matsuo K, et al. High-risk HLA allele mismatch combinations responsible for severe acute graft-versus-host disease and implication for its molecular mechanism. Blood 2007;110:2235-2241. https://doi.org/10.1182/blood-2007-02-072405
  14. Kanda Y, Kanda J, Atsuta Y, et al. Impact of a single human leucocyte antigen (HLA) allele mismatch on the outcome of unrelated bone marrow transplantation over two time periods: a retrospective analysis of 3003 patients from the HLA Working Group of the Japan Society for Blood and Marrow Transplantation. Br J Haematol 2013;161:566-577. https://doi.org/10.1111/bjh.12279
  15. Cho BS, Yoon JH, Shin SH, et al. Comparison of allogeneic stem cell transplantation from familial-mismatched/haploidentical donors and from unrelated donors in adults with high-risk acute myelogenous leukemia. Biol Blood Marrow Transplant 2012;18:1552-1563. https://doi.org/10.1016/j.bbmt.2012.04.008
  16. Kanda J, Ichinohe T, Kato S, et al. Unrelated cord blood transplantation vs related transplantation with HLA 1-antigen mismatch in the graft-versus-host direction. Leukemia 2013;27:286-294. https://doi.org/10.1038/leu.2012.203
  17. Lu DP, Dong L, Wu T, et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation. Blood 2006;107:3065-3073. https://doi.org/10.1182/blood-2005-05-2146
  18. Lee KH, Lee JH, Lee JH, et al. Reduced-intensity conditioning therapy with busulfan, fludarabine, and antithymocyte globulin for HLA-haploidentical hematopoietic cell transplantation in acute leukemia and myelodysplastic syndrome. Blood 2011;118:2609-2617. https://doi.org/10.1182/blood-2011-02-339838
  19. Akatsuka Y, Warren EH, Gooley TA, et al. Disparity for a newly identified minor histocompatibility antigen, HA-8, correlates with acute graft-versus-host disease after haematopoietic stem cell transplantation from an HLA-identical sibling. Br J Haematol 2003;123:671-675. https://doi.org/10.1046/j.1365-2141.2003.04676.x
  20. Fernandez-Vina MA, Klein JP, Haagenson M, et al. Multiple mismatches at the low expression HLA loci DP, DQ, and DRB3/4/5 associate with adverse outcomes in hematopoietic stem cell transplantation. Blood 2013;121:4603-4610. https://doi.org/10.1182/blood-2013-02-481945
  21. Aversa F, Tabilio A, Velardi A, et al. Treatment of high-risk acute leukemia with T-cell-depleted stem cells from related donors with one fully mismatched HLA haplotype. N Engl J Med 1998;339:1186-1193. https://doi.org/10.1056/NEJM199810223391702
  22. Henslee-Downey PJ, Abhyankar SH, Parrish RS, et al. Use of partially mismatched related donors extends access to allogeneic marrow transplant. Blood 1997;89:3864-3872.
  23. Beatty PG, Mori M, Milford E. Impact of racial genetic polymorphism on the probability of finding an HLA-matched donor. Transplantation 1995;60:778-783. https://doi.org/10.1097/00007890-199510270-00003
  24. Tiercy JM, Villard J, Roosnek E. Selection of unrelated bone marrow donors by serology, molecular typing and cellular assays. Transpl Immunol 2002;10:215-221. https://doi.org/10.1016/S0966-3274(02)00068-0
  25. Begovich AB, McClure GR, Suraj VC, et al. Polymorphism, recombination, and linkage disequilibrium within the HLA class II region. J Immunol 1992;148:249-258.
  26. Petersdorf EW, Longton GM, Anasetti C, et al. Association of HLA-C disparity with graft failure after marrow transplantation from unrelated donors. Blood 1997;89:1818-1823.
  27. Anasetti C, Hansen JA. Effect of HLA incompatibility in marrow transplantation from unrelated and HLA-mismatched related donors. Transfus Sci 1994;15:221-230. https://doi.org/10.1016/0955-3886(94)90134-1
  28. Flomenberg N, Baxter-Lowe LA, Confer D, et al. Impact of HLA class I and class II high-resolution matching on outcomes of unrelated donor bone marrow transplantation: HLA-C mismatching is associated with a strong adverse effect on transplantation outcome. Blood 2004;104:1923-1930. https://doi.org/10.1182/blood-2004-03-0803
  29. Ho VT, Ki HT, Liney D, et al. HLA-C mismatch is associated with inferior survival after unrelated donor nonmyeloablative hematopoietic stem cell transplantation. Bone Marrow Transplant 2006;37:845-850. https://doi.org/10.1038/sj.bmt.1705315
  30. Petersdorf EW, Gooley TA, Anasetti C, et al. Optimizing outcome after unrelated marrow transplantation by comprehensive matching of HLA class I and II alleles in the donor and recipient. Blood 1998;92:3515-3520.
  31. Kim HJ, Min WS, Eom KS, et al. Hematopoietic stem cell transplantation with using multinational unrelated donors for acute myelogenous leukemia. Korean J Hematol 2007;42:98-105. https://doi.org/10.5045/kjh.2007.42.2.98
  32. Kim HJ, Min WS, Cho BS, et al. Successful prevention of acute graft-versus-host disease using low-dose antithymocyte globulin after mismatched, unrelated, hematopoietic stem cell transplantation for acute myelogenous leukemia. Biol Blood Marrow Transplant 2009;15:704-717. https://doi.org/10.1016/j.bbmt.2009.02.010
  33. Petersdorf EW, Gooley T, Malkki M, et al. The biological significance of HLA-DP gene variation in haematopoietic cell transplantation. Br J Haematol 2001;112:988-994. https://doi.org/10.1046/j.1365-2141.2001.02655.x
  34. Varney MD, Lester S, McCluskey J, Gao X, Tait BD. Matching for HLA DPA1 and DPB1 alleles in unrelated bone marrow transplantation. Hum Immunol 1999;60:532-538. https://doi.org/10.1016/S0198-8859(99)00004-X
  35. Sasazuki T, Juji T, Morishima Y, et al. Effect of matching of class I HLA alleles on clinical outcome after transplantation of hematopoietic stem cells from an unrelated donor: Japan Marrow Donor Program. N Engl J Med 1998;339:1177-1185. https://doi.org/10.1056/NEJM199810223391701
  36. Morishima Y, Yabe T, Matsuo K, et al. Effects of HLA allele and killer immunoglobulin-like receptor ligand matching on clinical outcome in leukemia patients undergoing transplantation with T-cell-replete marrow from an unrelated donor. Biol Blood Marrow Transplant 2007;13:315-328. https://doi.org/10.1016/j.bbmt.2006.10.027
  37. McGlave PB, Shu XO, Wen W, et al. Unrelated donor marrow transplantation for chronic myelogenous leukemia: 9 years' experience of the national marrow donor program. Blood 2000;95:2219-2225.
  38. Giebel S, Locatelli F, Lamparelli T, et al. Survival advantage with KIR ligand incompatibility in hematopoietic stem cell transplantation from unrelated donors. Blood 2003;102:814-819. https://doi.org/10.1182/blood-2003-01-0091
  39. Kim HJ. HLA mismatched allogeneic hematopoietic stem cell transplantation. Korean J Hematol 2007;42:1-14. https://doi.org/10.5045/kjh.2007.42.1.1
  40. Kim HJ, Choi Y, Jeong HY, Min WS, Kim CC, Kim TG. Killer cell immunoglobulin-like receptor (KIR) analysis in adult Korean patients with acute myeloid leukemia. Korean J Hematol 2006;41:139-148. https://doi.org/10.5045/kjh.2006.41.3.139
  41. Norman PJ, Stephens HA, Verity DH, Chandanayingyong D, Vaughan RW. Distribution of natural killer cell immunoglobulin-like receptor sequences in three ethnic groups. Immunogenetics 2001;52:195-205. https://doi.org/10.1007/s002510000281
  42. Crum KA, Logue SE, Curran MD, Middleton D. Development of a PCR-SSOP approach capable of defining the natural killer cell inhibitory receptor (KIR) gene sequence repertoires. Tissue Antigens 2000;56:313-326. https://doi.org/10.1034/j.1399-0039.2000.560403.x
  43. Niokou D, Spyropoulou-Vlachou M, Darlamitsou A, Stavropoulos-Giokas C. Distribution of killer cell immunoglobulin-like receptors in the Greek population. Hum Immunol 2003;64:1167-1176. https://doi.org/10.1016/j.humimm.2003.08.100
  44. Yin XL, Guo KY, Ma HJ, et al. Killer immunoglobulin-like receptor gene distribution in Guangdong Han population. Di Yi Jun Yi Da Xue Xue Bao 2004;24:1416-1418.
  45. Venstrom JM, Pittari G, Gooley TA, et al. HLA-C-dependent prevention of leukemia relapse by donor activating KIR2DS1. N Engl J Med 2012;367:805-816. https://doi.org/10.1056/NEJMoa1200503
  46. Kim HJ, Choi Y, Min WS, et al. The activating killer cell immunoglobulin-like receptors as important determinants of acute graft-versus host disease in hematopoietic stem cell transplantation for acute myelogenous leukemia. Transplantation 2007;84:1082-1091. https://doi.org/10.1097/01.tp.0000285918.72930.35
  47. Kim SY, Choi HB, Yoon HY, et al. Influence of killer cell immunoglobulin-like receptor genotypes on acute graft-vs-host disease after unrelated hematopoietic stem cell transplantation in Koreans. Tissue Antigens 2007;69(Suppl 1):114-117. https://doi.org/10.1111/j.1399-0039.2006.762_9.x
  48. Kim HJ, Min WS, Kim YJ, Kim DW, Lee JW, Kim CC. Haplotype mismatched transplantation using high doses of peripheral blood CD34+ cells together with stratified conditioning regimens for high-risk adult acute myeloid leukemia patients: a pilot study in a single Korean institution. Bone Marrow Transplant 2005;35:959-964. https://doi.org/10.1038/sj.bmt.1704900
  49. Luznik L, O'Donnell PV, Symons HJ, et al. HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant 2008;14:641-650. https://doi.org/10.1016/j.bbmt.2008.03.005
  50. Goker H, Ozdemir E, Uz B, et al. Comparative outcome of reduced intensity and myeloablative conditioning regimen in HLA identical sibling allogeneic hematopoietic stem cell transplantation for acute leukemia patients: a single center experience. Transfus Apher Sci 2013;49:590-599. https://doi.org/10.1016/j.transci.2013.07.030
  51. Im HJ, Koh KN, Choi ES, et al. Excellent outcome of haploidentical hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia. Biol Blood Marrow Transplant 2013;19:754-759. https://doi.org/10.1016/j.bbmt.2013.01.023
  52. Koh KN, Im HJ, Kim BE, et al. Haploidentical haematopoietic stem cell transplantation using CD3 or CD3/CD19 depletion and conditioning with fludarabine, cyclophosphamide and antithymocyte globulin for acquired severe aplastic anaemia. Br J Haematol 2012;157:139-142. https://doi.org/10.1111/j.1365-2141.2011.08924.x
  53. Rachamim N, Gan J, Segall H, et al. Tolerance induction by "megadose" hematopoietic transplants: donor-type human CD34 stem cells induce potent specific reduction of host anti-donor cytotoxic T lymphocyte precursors in mixed lymphocyte culture. Transplantation 1998;65:1386-1393. https://doi.org/10.1097/00007890-199805270-00017
  54. Martelli MF, Reisner Y. Haploidentical 'megadose' CD34+ cell transplants for patients with acute leukemia. Leukemia 2002;16:404-405. https://doi.org/10.1038/sj.leu.2402382
  55. Franco A, Terenzi A, Tabilio A, et al. Full haplotype-mismatched hematopoietic stem cell transplantation: a phase II study in patients with acute leukemia at high risk of relapse. J Clin Oncol 2005;23:3447-3454. https://doi.org/10.1200/JCO.2005.09.117
  56. Lee KH, Lee JH, Lee JH, et al. Hematopoietic cell transplantation from an HLA-mismatched familial donor is feasible without ex vivo-T cell depletion after reduced-intensity conditioning with busulfan, fludarabine, and antithymocyte globulin. Biol Blood Marrow Transplant 2009;15:61-72.
  57. Kim HJ, Min WS, Choi SM, et al. Haplotype mismatch transplantation using high-dose CD34＋ cells with stratified new conditioning regimens in patients with acute myeloid leukemia. Korean J Hematol 2003;38:221-227.
  58. Farag SS, Fehniger TA, Ruggeri L, Velardi A, Caligiuri MA. Natural killer cell receptors: new biology and insights into the graft-versus-leukemia effect. Blood 2002;100:1935-1947. https://doi.org/10.1182/blood-2002-02-0350
  59. Zhao XY, Chang YJ, Huang XJ. Conflicting impact of alloreactive NK cells on transplantation outcomes after haploidentical transplantation: do the reconstitution kinetics of natural killer cells create these differences? Biol Blood Marrow Transplant 2011;17:1436-1442. https://doi.org/10.1016/j.bbmt.2011.05.020
  60. Ruggeri L, Capanni M, Urbani E, et al. Effectiveness of donor natural killer cell alloreactivity in mismatched hematopoietic transplants. Science 2002;295:2097-2100. https://doi.org/10.1126/science.1068440
  61. Wang Y, Liu DH, Liu KY, et al. Long-term follow-up of haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for the treatment of leukemia: nine years of experience at a single center. Cancer 2013;119:978-985. https://doi.org/10.1002/cncr.27761
  62. Cho BS, Choi HB, Kim HJ, Min WS, Kim CC, Kim TG. Typing by nested PCR-SSP approach raises a question about the feasibility of using this technique for detecting fetomaternal microchimerism. Leukemia 2006;20:896-898. https://doi.org/10.1038/sj.leu.2404153
  63. Lee JY, Park S, Kim DC, Shin SH, Min WS, Kim HJ. A VEGFR-3 antagonist increases IFN-gamma expression on low functioning NK cells in acute myeloid leukemia. J Clin Immunol 2013;33:826-837. https://doi.org/10.1007/s10875-013-9877-2

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