Format

Send to

Choose Destination
Bone Marrow Transplant. 2016 May;51(5):687-91. doi: 10.1038/bmt.2015.351. Epub 2016 Feb 8.

Risk factors and outcome of graft failure after HLA matched and mismatched unrelated donor hematopoietic stem cell transplantation: a study on behalf of SFGM-TC and SFHI.

Author information

1
Service d'hématologie adulte, Hôpital Saint-Louis, APHP, Paris, France.
2
Centre Méditerranéen de Médecine Moléculaire, INSERM U1065, Nice, France.
3
Hôpital Saint-Louis, Service de Biostatistique et Information Médicale, APHP, Paris, France.
4
Data Management of SFGM-TC, Centre Hospitalier Lyon Sud, Pierre-Bénite, France.
5
Laboratory of Histocompatibility, EFS Saint Etienne, Saint Etienne, France.
6
Laboratory of Histocompatibility, EFS Henri Mondor, Créteil, France.
7
Laboratory of Histocompatibility, EFS Pays de la Loire, Nantes, France.
8
Laboratory of Immunology, CHU Nice, Nice, France.
9
Laboratory of Histocompatibility, EFS Rhone Alpes, Lyon, France.
10
Laboratory of Immunology, CHU Limoges, France.
11
Laboratory of Immunology, CHU Toulouse, Toulouse, France.
12
Laboratory of Histocompatibility, EFS Normandie, Rouen, France.
13
Laboratory of Histocompatibility, EFS CA, Poitiers, France.
14
Laboratory of Immunology, CHU Lille, Lille, France.
15
Laboratory of Histocompatibility, EFS Rhône Alpes, Grenoble, France.
16
Laboratory of Histocompatibility, CHU Brest, France.
17
Laboratory of Immunology, Hôpital Robert Debré, APHP, Paris, France.
18
Laboratory of Histocompatibility, CHU Nancy, Nancy, France.
19
Laboratory of Histocompatibility, EFS Alpes Mediterrannée, Marseille, France.
20
Laboratory of Histocompatibility, EFS Clermont-Ferrand, Clermont-Ferrand, France.
21
Laboratory of Immunology, Hôpital Saint-Eloi, Montpellier, France.
22
Laboratory of Histocompatibility, EFS Rennes, France.
23
Laboratory of Immunology, CHU Necker-Enfants Malades, Paris, France.
24
Laboratory of Immunology and Histocompatibility, Hôpital Saint-Louis, APHP, Labex Transplantex, Paris, France.
25
Service d'hématologie greffe, Hôpital Saint-Louis, APHP, Paris, France.
26
Laboratory of Immunology and Immunogenetics, CNRS UMR 5164, CHU Bordeaux, France.
27
INSERM U1160, Hôpital Saint-Louis, Paris, France.

Abstract

Graft failure remains a severe complication of hematopoietic stem cell transplantation (HSCT). Several risk factors have already been published. In this study, we re-evaluated them in a large cohort who had the benefit of the recent experience in HSCT (2006-2012). Data from 4684 unrelated donor HSCT from 2006 to 2012 were retrospectively collected from centers belonging to the French Society for Stem Cell Transplantation. Among the 2716 patients for whom HLA typing was available, 103 did not engraft leading to a low rate of no engraftment at 3.8%. In univariate analysis, only type of disease and status of disease at transplant for malignant diseases remained significant risk factors (P=0.04 and P<0.0001, respectively). In multivariate analysis, only status of disease was a significant risk factor (P<0.0001). Among the 61 patients who did not engraft and who were mismatched for 1 HLA class I and/or HLA-DP, 5 donor-specific antibodies (DSAs) were detected but only 1 was clearly involved in graft failure, for the others their role was more questionable. Second HSCT exhibited a protective although not statistically significant effect on OS (hazard ratio=0.57 [0.32-1.02]). In conclusion, only one parameter (disease status before graft) remains risk factor for graft failure in this recent cohort.

PMID:
26855158
DOI:
10.1038/bmt.2015.351
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Nature Publishing Group
Loading ...
Support Center