The significance of XXXX matching on clinical outcome after @entity2149 , DR identical unrelated donor marrow transplantation.

@entity1 @entity5958 @entity2132 @entity2149 @entity1533
Despite matching for serologically defined @entity2149 , DR antigens, @entity2132 ( @entity2132 ) is a major complication contributing to increased morbidity and mortality in @entity1 who undergo marrow transplantation from unrelated donors. The extent to which unrecognized mismatching for alleles that encode @entity5958 -DR18 contribute to the increased risk of acute @entity2132 and overall survival is unknown. We analyzed 364 @entity1 and their @entity2149 , DR serologically matched donors to determine whether molecular typing of @entity1533 alleles can allow more accurate donor/recipient matching and thereby improve clinical outcome after marrow transplantation. @entity1533 alleles were typed by sequence-specific oligonucleotide probe hybridization methods. Selected alleles were confirmed by DNA sequencing. Of the 364 pairs, 305 were matched and 59 were mismatched for @entity1533 . The probability of moderate to severe acute @entity2132 was .48 for the matched and .70 for the mismatched @entity1 . Compared with mismatched @entity1 , the estimated relative risk (RR) of @entity2132 for matched @entity1 was .58 (95% confidence interval [CI], .40 to .85). @entity1533 matching decreased the risk of transplant-related mortality (RR, .66; 95% CI, .44 to .97) and was associated with decreased overall mortality (RR, .71; 95% CI, .51 to 1.0). Therefore, matching @entity1533 alleles of the donor and recipient decreases the risk of acute @entity2132 and improves survival after unrelated marrow transplantation. These results indicate that prospective matching of @entity1 and donors for @entity1533 alleles is warranted.
