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Marrow Transplantation from Related Donors Other Than HLA-Identical Siblings
Abstract
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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Citations
Cites
Regression Models and Life-Tables
Cox, D. R. (1972) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1972.tb00899.x · Cited by 39,793
Cited by
Bashey, A., Zhang, X., Sizemore, C. A., Manion, K., Brown, S., Holland, H. K., Morris, L. E., & Solomon, S. R. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.44.3523 · Cited by 499
The HLA system: Genetics, immunology, clinical testing, and clinical implications
Choo, S. Y. (2007) · Yonsei Medical Journal · doi:10.3349/ymj.2007.48.1.11 · Cited by 446
Transplantation of Anergic Histoincompatible Bone Marrow Allografts
Guinan, E. C., Boussiotis, V. A., Neuberg, D., Brennan, L. L., Hirano, N., Nadler, L. M., & Gribben, J. G. (1999) · New England Journal of Medicine · doi:10.1056/nejm199906033402202 · Cited by 429
Metadata
- Authors
- Beatty, P. G., Clift, R. A., Mickelson, E. M., Nisperos, B. B., Flournoy, N., Martin, P. J., Sanders, J. E., Stewart, P., Buckner, C. D., Storb, R., Thomas, E. D., & Hansen, J. A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1985-09-26
- Volume
- 313
- Issue
- 13
- Pages
- 765-771
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2317642686
- Cited by
- 816
- References
- 1
- FWCI
- 16.73
- Type
- journal article
- Language
- en
- Open access
- closed
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- Beatty, P. G., Clift, R. A., Mickelson, E. M., Nisperos, B. B., Flournoy, N., Martin, P. J., Sanders, J. E., Stewart, P., Buckner, C. D., Storb, R., Thomas, E. D., & Hansen, J. A. (1985). Marrow Transplantation from Related Donors Other Than HLA-Identical Siblings. New England Journal of Medicine. https://doi.org/10.1056/nejm198509263131301
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.