The clinical impact of human leukocyte antigen (HLA) disparities appears to vary among patients following allogeneic hematopoietic cell transplantation (HCT) who develop of grade II-IV acute graft-versus-host disease (GVHD), according to a study presented at the 2021 TCT Meetings of ASTCT & CIBMTR Digital Experience.
In this retrospective study, researchers obtained data from the Transplant Registry Unified Management Program (TRUMP) registry to assess 10,035 patients (median age, 48 years) who developed grade II-IV acute GVHD.
According to the results, among the entire study population, the probability of two-year overall survival (OS) after the onset of grade II-IV acute GVHD was 54.1% (95% confidence interval, 53.1-55.1). The researchers noted that in multivariate analysis, HLA ≥2-loci mismatched related donor and HLA 1-locus mismatched unrelated donor were both notably correlated with an inferior OS after the onset of grade II-IV acute GVHD. Moreover, in a subgroup analysis of related HCT, they observed that HLA ≥2-loci mismatched donor and use of peripheral blood stem cells (PBSCs) were linked to poor OS.
The researchers wrote, “In subgroup analysis of unrelated HCT, HLA mismatch and use of PBSCs were associated with an inferior OS. In subgroup analysis of cord blood transplant, presence of HLA disparity was not associated with an inferior OS.”
“We found that the clinical outcome after grade II-IV acute GVHD varied among different stem cell sources, and the impact of HLA disparity also differed,” the researchers concluded.
Read more at: https://tct.confex.com/tct/2021/meetingapp.cgi/Paper/16552.
Fuji S, et al. Impact of HLA Disparity on the Risk of Overall Mortality in Patients Who Developed Grade II-IV Acute Gvhd. Published for the 2021 TCT Meetings of ASTCT & CIBMTR Digital Experience; February 8-12, 2021.