José Carlos Jaime-Pérez, Magali Irais Ureño Segura, Adriana Domínguez-Villanueva, Nidia Karina Moncada-Saucedo, Sandra Iveth Mendoza-Ibarra, David Gómez-Almaguer
{"title":"HLA小体错配负荷对门诊单倍体相关外周血干细胞移植低强度调理后结果的影响","authors":"José Carlos Jaime-Pérez, Magali Irais Ureño Segura, Adriana Domínguez-Villanueva, Nidia Karina Moncada-Saucedo, Sandra Iveth Mendoza-Ibarra, David Gómez-Almaguer","doi":"10.1080/17474086.2025.2524522","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Molecular typing before hematopoietic stem cell transplantation (HSCT) at the eplet level is an emerging method to optimize HLA matching.</p><p><strong>Materials and methods: </strong>Patients who received outpatient haploidentical HSCT (Haplo-HSCT) from a sibling after reduced intensity conditioning (RIC) were studied. HLA class I and II mismatched eplets (MEs) load was determined using HLAMatchmaker software. A cutoff > or < 10 MEs was used to assess outcomes.</p><p><strong>Results: </strong>114 patients were studied. A locus B MEs load > 10 was associated with decreased overall survival (OS), (<i>p</i> = 0.049), and increased graft failure (GF) (<i>p</i> = 0.004). Mortality was higher with > 10 MEs in HLA-I locus B (<i>p</i> = 0.025), and HLA-II DRB1 (<i>p</i> = 0.026); chronic GVHD was higher with > 10 MEs in DRB1 (<i>p</i> = 0.009). Anti-HLA donor-specific antibodies (DSA) were more frequent in recipients with > 10 MEs load at locus C (<i>p</i> = 0.021) and DRB1 (<i>p</i> = 0.002). MEs load > 10 at locus C and DRB1 were associated with anti-HLA DSA. Infection (<i>p</i> = 0.012), DSA (<i>p</i> = 0.014), and relapse (<i>p</i> = 0.001) were associated with lower OS, while multitransfusion (<i>p</i> = 0.035), aGVHD (<i>p</i> = 0.035) and infection (<i>p</i> = 0.021) with reduced event-free survival (EFS).</p><p><strong>Conclusion: </strong>HLA MEs load > 10 in locus B was associated with reduced OS, and in locus DRB1 with higher death rate and cGVHD after outpatient sibling haplo-HSCT using RIC.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"1-9"},"PeriodicalIF":2.3000,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of HLA eplets mismatch load on outcomes of outpatient haploidentical-related stem cell transplantation from peripheral blood after reduced intensity conditioning.\",\"authors\":\"José Carlos Jaime-Pérez, Magali Irais Ureño Segura, Adriana Domínguez-Villanueva, Nidia Karina Moncada-Saucedo, Sandra Iveth Mendoza-Ibarra, David Gómez-Almaguer\",\"doi\":\"10.1080/17474086.2025.2524522\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Molecular typing before hematopoietic stem cell transplantation (HSCT) at the eplet level is an emerging method to optimize HLA matching.</p><p><strong>Materials and methods: </strong>Patients who received outpatient haploidentical HSCT (Haplo-HSCT) from a sibling after reduced intensity conditioning (RIC) were studied. HLA class I and II mismatched eplets (MEs) load was determined using HLAMatchmaker software. A cutoff > or < 10 MEs was used to assess outcomes.</p><p><strong>Results: </strong>114 patients were studied. A locus B MEs load > 10 was associated with decreased overall survival (OS), (<i>p</i> = 0.049), and increased graft failure (GF) (<i>p</i> = 0.004). Mortality was higher with > 10 MEs in HLA-I locus B (<i>p</i> = 0.025), and HLA-II DRB1 (<i>p</i> = 0.026); chronic GVHD was higher with > 10 MEs in DRB1 (<i>p</i> = 0.009). Anti-HLA donor-specific antibodies (DSA) were more frequent in recipients with > 10 MEs load at locus C (<i>p</i> = 0.021) and DRB1 (<i>p</i> = 0.002). MEs load > 10 at locus C and DRB1 were associated with anti-HLA DSA. Infection (<i>p</i> = 0.012), DSA (<i>p</i> = 0.014), and relapse (<i>p</i> = 0.001) were associated with lower OS, while multitransfusion (<i>p</i> = 0.035), aGVHD (<i>p</i> = 0.035) and infection (<i>p</i> = 0.021) with reduced event-free survival (EFS).</p><p><strong>Conclusion: </strong>HLA MEs load > 10 in locus B was associated with reduced OS, and in locus DRB1 with higher death rate and cGVHD after outpatient sibling haplo-HSCT using RIC.</p>\",\"PeriodicalId\":12325,\"journal\":{\"name\":\"Expert Review of Hematology\",\"volume\":\" \",\"pages\":\"1-9\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-06-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Hematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/17474086.2025.2524522\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17474086.2025.2524522","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Impact of HLA eplets mismatch load on outcomes of outpatient haploidentical-related stem cell transplantation from peripheral blood after reduced intensity conditioning.
Background: Molecular typing before hematopoietic stem cell transplantation (HSCT) at the eplet level is an emerging method to optimize HLA matching.
Materials and methods: Patients who received outpatient haploidentical HSCT (Haplo-HSCT) from a sibling after reduced intensity conditioning (RIC) were studied. HLA class I and II mismatched eplets (MEs) load was determined using HLAMatchmaker software. A cutoff > or < 10 MEs was used to assess outcomes.
Results: 114 patients were studied. A locus B MEs load > 10 was associated with decreased overall survival (OS), (p = 0.049), and increased graft failure (GF) (p = 0.004). Mortality was higher with > 10 MEs in HLA-I locus B (p = 0.025), and HLA-II DRB1 (p = 0.026); chronic GVHD was higher with > 10 MEs in DRB1 (p = 0.009). Anti-HLA donor-specific antibodies (DSA) were more frequent in recipients with > 10 MEs load at locus C (p = 0.021) and DRB1 (p = 0.002). MEs load > 10 at locus C and DRB1 were associated with anti-HLA DSA. Infection (p = 0.012), DSA (p = 0.014), and relapse (p = 0.001) were associated with lower OS, while multitransfusion (p = 0.035), aGVHD (p = 0.035) and infection (p = 0.021) with reduced event-free survival (EFS).
Conclusion: HLA MEs load > 10 in locus B was associated with reduced OS, and in locus DRB1 with higher death rate and cGVHD after outpatient sibling haplo-HSCT using RIC.
期刊介绍：
Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.
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