Changes to This Summary (04/08/2014)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Added a Figure about human leukocyte antigen (HLA) allele duplications and types of mismatches.
Added text about how HLA allele duplication in a donor or recipient results in a “half” match and a mismatch that will either occur in a direction that promotes graft-versus-host disease (GVHD) (GVH-O) or a direction that promotes rejection (R-O). The 7/8 mismatched in only the R-O direction is preferred over GVH-O and bidirectional mismatches (cited Hurley et al. as reference 10).
Added text about the results of a large Center for International Bone Marrow Transplant Research/Eurocord study; best outcome was noted with 8/8 allele matching. Cord blood transplant patients with one to four allele mismatches required a higher cell dose to decrease transplant-related mortality (cited Eapen et al. as reference 12).
Added Kanda et al. as reference 14.
Added text about a retrospective study of Japanese children with acute leukemia that compared 90 children who received peripheral blood stem cells (PBSCs) with 571 children who received bone marrow; the study confirmed higher transplant-related mortality due to GVHD and inferior survival among the children who received PBSCs (cited Shinzato et al. as reference 24).
Revised text to state that donor-derived natural killer cells in the post-HCT setting have been shown to promote engraftment, decrease GVHD, lessen relapse of hematological malignancies, and improve survival (cited Bari et al. as reference 46).
Added text to state that one small, retrospective, single-center study showed a benefit from corticosteroid therapy; this requires further validation (cited Myers et al. as reference 11).
Added Richardson et al. as reference 14.
Added text to state that studies have linked transplant-associated microangiopathy with disruption of alternative complement pathways (cited Jodele et al. as reference 16).
Added Sun et al. as reference 1.
This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.