Sep 26, 1985

Marrow transplantation from related donors other than HLA-identical siblings

The New England Journal of Medicine
P G BeattyR Storb


Marrow transplantation has generally been limited to patients with a sibling who is genotypically identical for HLA. In a study of the acceptable limits of HLA incompatibility, 105 consecutive patients with hematologic cancers who received marrow grafts from haploidentical donors (study group) were compared with 728 similar patients concurrently receiving grafts from HLA genotypically identical siblings (control group). The unshared haplotypes differed variably: 12 were phenotypically but not genotypically identical for HLA-A, HLA-B, and HLA-D; 63 differed at one locus (A, B, or D); 24 at two loci; and 6 at three. A higher proportion of study patients had delayed engraftment, granulocytopenia, or graft rejection. Acute graft versus host disease occurred earlier and with greater frequency in study patients. The risk of the disease did not correlate with disparity for Class I (A or B) versus Class II (D-region) loci. Thus, incompatibility for HLA has an important effect on the course after clinical marrow transplantation. In spite of these complications, there was no statistically significant difference in the survival of the study patients and control patients who received their transplants during remission.

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Mentioned in this Paper

Hematology (Discipline)
Acute GVH Disease
Graft Acceptance
Graft-vs-Host Disease
HLA-B gene
HLA Antigens
Acute Disease
Cancer Remission
Human Leukocyte Antigen (HLA) A Antigen Typing (Procedure)
Graft Rejection

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