TY - JOUR
T1 - The effect of NIMA matching in adult unrelated mismatched hematopoietic stem cell transplantation – a joint study of the Acute Leukemia Working Party of the EBMT and the CIBMTR
AU - Pingel, Julia
AU - Wang, Tao
AU - Hagenlocher, Yvonne
AU - Hernández-Frederick, Camila J.
AU - Nagler, Arnon
AU - Haagenson, Michael D.
AU - Fleischhauer, Katharina
AU - Hsu, Katharine C.
AU - Verneris, Michael R.
AU - Lee, Stephanie J.
AU - Mohty, Mohamad
AU - Polge, Emmanuelle
AU - Spellman, Stephen R.
AU - Schmidt, Alexander H.
AU - van Rood, Jon J.
N1 - Publisher Copyright:
© 2018, Springer Nature Limited.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Hematological malignancies can be cured by unrelated donor allogeneic HSCT and outcomes are optimized by high-resolution HLA matching at HLA-A, -B, -C, -DRB1 and -DQB1 (10/10 match). If a 10/10 match is unavailable, 9/10 matches may be suitable. Fetal exposure to non-inherited maternal antigens (NIMA) may impart lifelong NIMA tolerance modulating the immune response, as shown in adult haploidentical transplantation. In cord blood transplantation, NIMA matching lowered rates of aGvHD and TRM; in haploidentical transplantation, sibling donors with non-shared maternal antigens showed less grade II-IV aGvHD. This retrospective analysis examined if 9/10 matched unrelated donor HSCT benefits from NIMA matching. DKMS contacted 1,735 donors and obtained 733 (42%) maternal samples. NIMA-matched and -mismatched cases with a minimum follow-up of 1 year were compared by univariate and multivariate analyses adjusted for co-variates for OS, DFS, relapse, TRM and a/cGvHD. The study population (N = 445) comprised 31 NIMA-matched and 414 NIMA-mismatched cases. No significant differences between NIMA-matched and NIMA-mismatched groups were found for any outcomes with similar OS and TRM rates within both groups. This study provides the proof of principle that NIMA matching is possible in the unrelated donor HSCT setting; larger studies may be able to provide significant results.
AB - Hematological malignancies can be cured by unrelated donor allogeneic HSCT and outcomes are optimized by high-resolution HLA matching at HLA-A, -B, -C, -DRB1 and -DQB1 (10/10 match). If a 10/10 match is unavailable, 9/10 matches may be suitable. Fetal exposure to non-inherited maternal antigens (NIMA) may impart lifelong NIMA tolerance modulating the immune response, as shown in adult haploidentical transplantation. In cord blood transplantation, NIMA matching lowered rates of aGvHD and TRM; in haploidentical transplantation, sibling donors with non-shared maternal antigens showed less grade II-IV aGvHD. This retrospective analysis examined if 9/10 matched unrelated donor HSCT benefits from NIMA matching. DKMS contacted 1,735 donors and obtained 733 (42%) maternal samples. NIMA-matched and -mismatched cases with a minimum follow-up of 1 year were compared by univariate and multivariate analyses adjusted for co-variates for OS, DFS, relapse, TRM and a/cGvHD. The study population (N = 445) comprised 31 NIMA-matched and 414 NIMA-mismatched cases. No significant differences between NIMA-matched and NIMA-mismatched groups were found for any outcomes with similar OS and TRM rates within both groups. This study provides the proof of principle that NIMA matching is possible in the unrelated donor HSCT setting; larger studies may be able to provide significant results.
UR - http://www.scopus.com/inward/record.url?scp=85054383719&partnerID=8YFLogxK
U2 - 10.1038/s41409-018-0345-8
DO - 10.1038/s41409-018-0345-8
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C2 - 30279575
AN - SCOPUS:85054383719
SN - 0268-3369
VL - 54
SP - 849
EP - 857
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 6
ER -
