TY - JOUR AU - Betül Oran, AU - Kai Cao, AU - Rima M. Saliba, AU - Katayoun Rezvani, AU - Marcos de Lima, AU - Sairah Ahmed, AU - Chitra M. Hosing, AU - Uday R. Popat, AU - Yudith Carmazzi, AU - Partow Kebriaei, AU - Yago Nieto, AU - Gabriela Rondon, AU - Dana Willis, AU - Nina Shah, AU - Simrit Parmar, AU - Amanda Olson, AU - Brandt Moore, AU - David Marin, AU - Rohtesh Mehta, AU - Marcelo Fernández-Viña, AU - Richard E. Champlin, AU - Elizabeth J. Shpall, PY - 2015/10/02 Y2 - 2024/03/28 TI - Better allele-level matching improves transplant-related mortality after double cord blood transplantation JF - Haematologica JA - haematol VL - 100 IS - 10 SE - Articles DO - 10.3324/haematol.2015.127787 UR - https://haematologica.org/article/view/7531 SP - 1361-1370 AB - Cord blood transplant requires less stringent human leukocyte antigen matching than unrelated donors. In 133 patients with hematologic malignancies who engrafted after double cord blood transplantation with a dominant unit, we studied the effect of high resolution testing at 4 loci (-A, -B, -C, -DRB1) for its impact on 2-year transplant-related mortality. Ten percent of the dominant cord blood units were matched at 7–8/8 alleles using HLA-A, -B, -C, and -DRB1; 25% were matched at 6/8, 40% at 5/8, and 25% at 4/8 or less allele. High resolution typing at 4 loci showed that there was no 2-year transplant-related mortality in 7–8/8 matched patients. Patients with 5–6/8 matched dominant cord blood units had 2-year transplant-related mortality of 39% while patients with 4/8 or less matched units had 60%. Multivariate regression analyses confirmed the independent effect of high resolution typing on the outcome when adjusted for age, diagnosis, CD34+ cell dose infused, graft manipulation and cord to cord matching. The worst prognostic group included patients aged over 32 years with 4/8 or less matched cord blood units compared with patients who were either younger than 32 years old independent of allele-level matching, or aged over 32 years but with 5–6/8 matched cord blood units (Hazard Ratio 2.2; 95% confidence interval: 1.3–3.7; P