scholarly journals HLA-B Leader and Survivorship after HLA-Mismatched Unrelated Donor Transplantation

Blood ◽  
2020 ◽  
Author(s):  
Effie W Petersdorf ◽  
Philip Stevenson ◽  
Mats Bengtsson ◽  
Dianne De Santis ◽  
Valerie Dubois ◽  
...  
Keyword(s):  
Hematopoietic Cell Transplantation ◽  
Unrelated Donor ◽  
Blood Disorders ◽  
Regression Methods ◽  
New Information ◽  
Life Threatening ◽  
Unrelated Donors ◽  
The Impact ◽  
Selection Of ◽  
Better Than

Hematopoietic-cell transplantation (HCT) from HLA-mismatched unrelated donors can cure life-threatening blood disorders but its success is limited by graft-versus-host disease (GVHD). HLA-B leaders encode methionine (M) or threonine (T) at position 2 and give rise to TT, MT or MM genotypes. The dimorphic HLA-B leader informs GVHD risk in HLA-B-mismatched HCT. If the leader influences outcome in other HLA-mismatched transplant settings, the success of HCT could be improved for future patients. We determined leader genotypes for 11872 patients transplanted between 1988 and 2016 from unrelated donors with one HLA-A -B,-C,-DRB1 or -DQB1 mismatch. Multivariate regression methods were used to evaluate risks associated with patient leader genotype according to the mismatched HLA locus and with HLA-A,-B,-C,-DRB1 or -DQB1 mismatching according to patient leader genotype. The impact of the patient leader genotype on acute GVHD and mortality varied across different mismatched HLA loci. Non-relapse mortality was higher among HLA-DQB1-mismatched MM patients compared to HLA-DQB1-mismatched TT patients (hazard ratio 1.35; P = .01). Grades III-IV GVHD risk was higher among HLA-DRB1-mismatched MM or MT patients compared to HLA-DRB1-mismatched TT patients (odds ratio 2.52 and 1.51, respectively). Patients tolerated a single HLA-DQB1 mismatch better than mismatches at other loci. Outcome after HLA-mismatched transplantation depends on the HLA-B leader dimorphism and the mismatched HLA locus. The patient's leader variant provides new information on the limits of HLA mismatching. The success of HLA-mismatched unrelated transplantation might be enhanced through the judicious selection of mismatched donors for a patient's given leader genotype.

scholarly journals Predicted Indirectly ReCognizable HLA Epitopes (PIRCHE) Are Associated with Poorer Outcome after Single Mismatch Unrelated Donor Stem Cell Transplantation: A Study of the Cooperative Transplant Study Group (KTS) of the German Group for Bone Marrow and Stem Cell Transplantation (DAG-KBT)

2019 ◽  
Vol 46 (5) ◽  
pp. 370-375
Author(s):  
Francis Ayuk ◽  
Martin Bornhäuser ◽  
Matthias Stelljes ◽  
Tatjana Zabelina ◽  
Eva-Maria Wagner ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Negative Impact ◽  
Study Cohort ◽  
Unrelated Donor ◽  
Unrelated Donors ◽  
The Impact ◽  
Hla Mismatches ◽  
Selection Of

There is no established standard for selection of mismatched unrelated donors. Indirect recognition of HLA mismatches can be predicted using the model of “Predicted Indirectly ReCognizable HLA Epitopes” (PIRCHE). We performed a multicenter retrospective study evaluating the impact PIRCHE on outcome after allogeneic stem cell transplantation (allo-HSCT) from single mismatched (HLA 9/10 matched) unrelated donors. The study cohort included 424 adult recipients of HLA 9/10 matched unrelated donor transplants (9/10 MUD), treated for AML or MDS at 6 transplant centers across Germany. Detection of PIRCHE was associated with lower overall survival (OS) (47 vs. 57%, p = 0.04), higher non-relapse mortality (NRM) (32 vs. 20%, p = 0.05), and higher incidence of chronic graft-versus-host disease (GVHD) (49 vs. 31%, p = 0.04) at 2 years. Cumulative incidence of acute GVHD grade 2–4 at 6 months was not significantly different (30 vs. 23%, p = 0.2). OS for 9/10 MUD with no PIRCHE was similar to 10/10 MUD (57 vs. 55%). In multivariate analysis, PIRCHE retained negative impact on OS (RR 1.5, 95% CI 1.0–2.1, p = 0.03) and NRM (RR 1.7, 95% CI 1.0–2.9, p = 0.03). To the best of our knowledge, for the first time, we show the association of PIRCHE and survival outcome after allo-HSCT. The PIRCHE model, if validated in an independent cohort, may allow selection of permissible HLA mismatches that enable improved transplant outcome.

High Numbers of CD34+ Cells/kg and CD3+ Cells/kg Have No Negative Impact on the Incidence of Severe GvHD and Survival in a Large Series of Children Undergoing Unmanipulated Allogeneic HCT from Matched or Mismatched Unrelated Donors.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5390-5390
Author(s):  
Krzysztof Kalwak ◽  
Joanna Owoc-Lempach ◽  
Ewa Gorczynska ◽  
Marek Ussowicz ◽  
Dominik Turkiewicz ◽  
...  
Keyword(s):  
Hematopoietic Cell Transplantation ◽  
Negative Impact ◽  
Unrelated Donor ◽  
Matched Group ◽  
Cd34 Cells ◽  
Impact On Survival ◽  
Unrelated Donors ◽  
Mismatched Donor ◽  
Selection Of

Abstract The aim of the study was to analyze the correlation between the number of transplanted CD34+ cells and CD3+ cells and the incidence of severe Graft versus Host Disease (GvHD) in children undergoing allogeneic hematopoietic cell transplantation from HLA-matched or mismatched unrelated donors. 115 patients (median age 11.4, range 0.7 – 31.6; ALL n=41, AML n=22, CML n=21, MDS/JMML n=10, NHL/HD n=4, SAA/FA n=13, SCID/WAS n=4) underwent unmanipulated allogeneic BMT (n=34) or PBSCT (n=81) from unrelated donors between 1999 and 2005. There were 88 matched- and 27 mismatched donor-recipient pairs, respectively (acc. to ALL SZT - BFM 2003 protocol). Among 88 matched pairs, 51 were 10 out of 10 HLA-allele matched (High Resolution Class I and II typed), whereas in another 37 cases 9 out of 10 alleles were matched. In the mismatched group there were 22 pairs with a 8 out of 10 allele-match and 5 pairs with 7 out of 10 allele-match, respectively. No single DRB1* mismatch was accepted. A distinct correlation between the degree of HLA-match and the risk of grades III-IV aGvHD was found (p=0.05), which occurred in 11 out of 27 pts in the mismatched group (40.7%) and in 19 out of 88 pts in the matched group (21.6%). No difference between the 2 groups was observed with regard to the incidence of extensive cGvHD. No correlation was found between the number of transplanted CD34+ cells/kg or CD3+ cells/kg and the incidence of aGvHD grades III–IV or extensive cGvHD. Median numbers of transplanted CD34+ cells/kg and CD3+ cells/kg were 7.7 × 106 (10.9 × 106) and 2.6 × 108 (3.3 × 108) respectively in the group of patients with grades III–IV aGvHD (extensive cGvHD) and 9.3 × 106 (8.8 × 106) and 3.4 × 108 (3.1 × 108) respectively in the group without these complications. Pts in the mismatched group were given slightly higher numbers of CD3+ cells/kg (4.9 vs 3.0 × 108 in the matched group) and similar numbers of CD34+ cells/kg (median 8.1 vs 8.9 × 106 in the matched group). Despite a higher incidence of severe aGvHD in the mismatched group, probability of 5-year survival was in contrast slightly better in the mismatched group (pS = 0.59 vs pS = 0.48 in the matched group, p=NS). Seventeen from 27 pts in the mismatched group remain alive (62.9%). Median follow-up of all 63 surviving pts (55%) is 21 months (range 6 – 69). Neither degree of HLA match, nor the source of stem cells (PB vs BM), nor number of transplanted CD34 (less or more than 8 × 106/kg) or CD3 cells/kg had an impact on survival. In conclusion, there seems to be no correlation between the numbers of transplanted CD34+ cells/kg and/or CD3+ cells/kg and the incidence of severe GvHD in the unrelated donor setting in children. It is safe and feasible to perform allogeneic transplants from unrelated mismatched donors, provided a detailed selection of more than 1 HLA-allele-mismatched donors is performed. This conclusion remains in contrast with the ALL SZT-BFM 2003 protocol, which requires extensive T-cell depletion in case of mismatched donor-recipient pairs. High number of transplanted CD34+ cells seems to be a positive factor influencing engraftment and survival in this constellation. There seems to be not necessary to limit the number of transplanted CD34+ cells to 6 or 8 × 106/kg, which had been previously suggested by studies performed in Europe or USA in adults.

scholarly journals Childhood Maltreatment, Cortical and Amygdala Morphometry, Functional Connectivity, Laterality, and Psychopathology

2019 ◽  
Vol 24 (4) ◽  
pp. 458-465 ◽  
Author(s):  
Martin H. Teicher ◽  
Alaptagin Khan
Keyword(s):  
Functional Connectivity ◽  
Child Maltreatment ◽  
Childhood Maltreatment ◽  
Prefrontal Cortical ◽  
Preventable Risk Factor ◽  
New Information ◽  
Increase Risk ◽  
The Impact ◽  
New Evidence ◽  
Better Than

Child maltreatment (CM) is the most important preventable risk factor for psychopathology and there is a pressing need to understand how CM gets ‘under the skin’ to markedly increase risk in some individuals as well as a comparable effort to identify factors associated with better than expected outcomes in other individuals. This special issue of Child Maltreatment provides a series of sophisticated studies on the neurobiological impact of CM, of which we have chosen 4 articles to comment on.The articles by Oshri et al., and Peveril, Sheridan, Busso & McLaughlin are amygdala centric and provide important new information on the impact of CM on the morphology and functional connectivity of this highly stress susceptible structure. The article by Demers et al., presents data from a longitudinal study that illustrates the potentially disruptive effects of CM on the association between maternal relationship quality, frontal cortical development and symptomatology. Finally, the De Bellis et al., study addresses the pressing question, which we have labeled the ‘ecophenotype hypothesis’, that postulates that maltreated and non-maltreated individuals with the same primary DSM diagnosis are clinically and neurobiologically distinct, and provides new evidence for a specific prefrontal cortical neurobiological abnormality in the maltreated subtype.

scholarly journals 2696. Breakthrough Toxoplasmosis While on Atovaquone Prophylaxis Following Allogeneic Hematologic Stem Cell Transplantation

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S948-S948 ◽  
Author(s):  
Teresa A Chueng ◽  
Mohammed A Raja ◽  
Michele I Morris ◽  
Krishna V Komanduri ◽  
Jose F Camargo
Keyword(s):  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Preemptive Therapy ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Unrelated Donor ◽  
Seropositive Woman ◽  
Life Threatening ◽  
Related Donor ◽  
Initiation Of Therapy ◽  
Immunocompromised Hosts

Abstract Background The opportunistic parasite Toxoplasma causes life-threatening complications in immunocompromised hosts such as hematopoietic cell transplantation (HCT) recipients. Trimethoprim-sulfamethoxazole (TMP-SMX) is the agent of choice in preventing Pneumocystis jirovecii pneumonia and Toxoplasma, but bone marrow suppression often precludes its use. Broad-spectrum atovaquone also targets protozoan tachyzoite and cyst forms, but few studies examine its efficacy in prophylaxis among this vulnerable population. We present two HCT patients experiencing breakthrough toxoplasmosis despite compliance with atovaquone prophylaxis. Methods Review of literature and electronic medical records. Results Case 1. A 68-year-oldToxoplasma seropositive woman with myelodysplastic syndrome underwent Flu-Mel-ATG-matched unrelated donor HCT. On day +68 post HCT, she presented with encephalopathy. MRI brain revealed solid and ring-enhancing lesions correlating with positive CSF T. gondii PCR. Serum DNA PCR was negative. She received 12 weeks of sulfadiazine, pyrimethamine, and leucovorin with clinical and radiological improvement. Atovaquone prophylaxis was restarted given pancytopenia intolerance of TMP-SMX. Despite compliance, she experienced recurrent central nervous system toxoplasmosis. Her demise followed an unrelated ischemic cerebrovascular accident. Case 2. A 53-year-old Toxoplasma seropositive woman with CMV viremia and severe aplastic anemia limiting TMP-SMX use presented with pancytopenia on day +46 after HCT. Diagnosed with graft failure, routine screening revealed positive Toxoplasma PCR while on atovaquone prophylaxis. Toxoplasma PCR became negative after preemptive therapy. She underwent a second Flu-Cy-ATG-TBI-matched related donor HCT. 2 months later, medication noncompliance led to readmission with CMV viremia and culture-negative sepsis. Blood Toxoplasma PCR was positive at the time of death. Conclusion Toxoplasmosis prophylaxis failure can occur in allogeneic HCT recipients receiving atovaquone. When possible, TMP-SMX should remain first-line agent for this indication. In those unable to tolerate TMP-SMX, close clinical and Toxoplasma PCR monitoring may help identify reactivation and facilitate early initiation of therapy. Disclosures All authors: No reported disclosures.

scholarly journals On-the-Fly Prediction of Orbit Corrections for RTK Positioning

2006 ◽  
Vol 59 (2) ◽  
pp. 321-334 ◽  
Author(s):  
Ahmed El-Mowafy
Keyword(s):  
Equations Of Motion ◽  
Estimation Accuracy ◽  
Double Exponential ◽  
Double Exponential Smoothing ◽  
Orbital Correction ◽  
Exponential Smoothing Method ◽  
The Impact ◽  
Multiple Reference ◽  
Selection Of ◽  
Better Than

In this study, a method is presented to maintain real-time positioning at the decimetre-level accuracy during breaks in reception of the measurement corrections from multiple reference stations. The method is implemented at the rover by estimating prediction coefficients of the corrections during normal RTK positioning, and uses these coefficients to predict the corrections when reception of the corrections is temporarily lost. The paper focuses on one segment of this method, the on-the-fly prediction of orbital corrections. Frequently, only a few minutes of data representing short orbit ‘arcs’ are available to the user before losing radio transmission. Thus, it would be hard for the rover to predict the satellite positions using equations of motion. An alternative method is proposed. In this method, GPS orbital corrections are predicted as a time series and are added to the initial positions computed from the broadcast ephemeris to compute relatively accurate satellite positions. Different prediction approaches were investigated. Results show that the double exponential smoothing method and Winters' method can be successfully applied. The latter, however, has a better performance. The impact of the data length used for estimation of the prediction coefficients and the selection of seasonal lengths in Winters' method were investigated and some values were recommended. In general, the method can give orbital correction estimation accuracy of less than 5 cm after 15 minutes of prediction. This will result in a positioning accuracy better than 5 cm.

Equality Of Access To Transplant For Ethnic Minority Patients Through Use Of Cord Blood and Haploidentical Transplants

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2138-2138 ◽  
Author(s):  
Robert N Lown ◽  
Steven GE Marsh ◽  
Helen Blake ◽  
Sergio Querol ◽  
Irina Evseeva ◽  
...  
Keyword(s):  
Cord Blood ◽  
Ethnic Groups ◽  
Unrelated Donor ◽  
Northern European ◽  
Equal Chance ◽  
Significant Difference ◽  
Unrelated Donors ◽  
The Impact ◽  
Unrelated Adult ◽  
Matched Donor

Abstract It is well accepted that patients of ethnic minorities who lack a sibling donor are poorly represented on the international unrelated donor panels. As recently as 2000, only 30% of such patients were able to find an unrelated donor suitable for transplantation. Historically these patients would have either not been transplanted, or would receive transplants from unrelated donors with two or more HLA mismatches. Continued expansion of the international donor inventory, and the advent of cord blood and haploidentical transplantation has improved the prospects for transplantation for such patients and, through the expertise of search staff within donor registries and histocompatibility laboratories, transplant centres are increasingly able to identify early on those patients who are unlikely to find a well-matched unrelated adult donor. Surprisingly, however, few contemporary data have been published to show the impact of these search strategies and alternative stem cell sources on provision of transplant to those of non-white Northern European origin. We consecutively enrolled and prospectively followed up (from search request to last contact or death) 332 patients referred by four UK transplant centres to the Anthony Nolan Graft Identification and Advisory Service (GIAS) for identification of an unrelated adult donor or cord blood unit. Of these, 248 (74.7%) were of white Northern European (WNE) descent, and 84 (25.3%) non-WNE. The underlying disease did not differ significantly between ethnicities. The median number of UK donors listed on the search report was 8 (range 0 to 3395) and 0 (0 to 42) respectively, and on BMDW 127 (0 to 38245) and 5.5 (0 to 380) respectively. 69.3% of WNE and 20.5% of non-WNE patients found a 10/10 HLA-matched donor at confirmatory typing (CT) (p<0.001); 96.3% of WNE and 61.4% of non-WNE found at least a 9/10 HLA-matched donor (p<0.001). Non-WNE patients had more cord blood transplants (21.3% vs 3.8%, p<0.001) and more haploidentical transplants (10.6% vs 1.3%, p<0.001). There was no significant difference in the number of patients reaching transplant (WNE 63.3%, non-WNE 56.0%, p=0.185) when considering all of the graft sources. Patients of non-WNE background had a significantly slower time from first CT request to identification of an unrelated donor for transplant (median 27 days vs 33.5 days, p= 0.02), and from search request to transplant with any graft source (median 110 days vs 132 days, p=0.03). However, when the cumulative incidence of transplantation with death as a competing risk was considered, there was no difference between ethnic groups (log rank p=0.185, see figure). The median time from search request to transplant by graft source was 120.5 days for adult unrelated donors (n=179), 143 days for cord blood (n=16) and 91 days for haploidentical donors (n=6) (p=0.626). These data show that the chance of receiving a transplant for patients of a non-WNE descent has improved considerably compared to historical literature. The majority of non-WNE patients were able to find a 9 or 10/10 matched donor, and many of those who could not were afforded the option of a cord blood or haploidentical donor transplant within a similar timescale. Whilst times to transplant do remain slightly longer for non-WNE patients, mainly due to a more protracted CT stage, they now stand an equal chance of reaching transplant. However, whether survival following transplant is similar between ethnic groups remains to be seen. Disclosures: No relevant conflicts of interest to declare.

Exploring the Determinants of Broadway Show Success

1998 ◽  
Vol 35 (3) ◽  
pp. 370-383 ◽  
Author(s):  
Srinivas K. Reddy ◽  
Vanitha Swaminathan ◽  
Carol M. Motley
Keyword(s):  
New York ◽  
Information Sources ◽  
New York Times ◽  
Differential Impact ◽  
Daily News ◽  
Types Of Information ◽  
Ticket Prices ◽  
The Impact ◽  
Selection Of ◽  
Better Than

This study investigates the determinants of success of an experiential good: Broadway shows. The authors focus on the sources and types of information used in the selection of an artistic event and discuss the impact of critics’ reviews on the length of a show's run and attendance. In addition, the authors empirically determine the influence of other variables, such as previews, newspaper advertising, ticket prices, show type, talent characteristics, and timing of opening. The results indicate that New York newspaper theater critics have a significant impact on the success of Broadway shows. It is also found that the newspaper critics have a differential impact, with the critic from the New York Times yielding nearly twice as much influence as critics from the Daily News or the New York Post. Theater critics, it appears, are not only predictors but influencers as well. Among the various show types, musicals appear to fare better than other categories of shows. Previews have a significant impact on the attendance, but not on the longevity, of Broadway shows. Advertising also has a significant impact on both longevity and attendance. However, the characteristics of the key talent do not have a consistently significant influence on show success. In addition, ticket prices do not have a significant relationship with either longevity or attendance. The results indicate that there is an overwhelming impact of information sources, particularly the influence of critics’ reviews, on the success of Broadway shows. The authors discuss the implications of these results for the theater industry.

scholarly journals Selection of matched unrelated donors moving forward: from HLA allele counting to functional matching

Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 532-538 ◽  
Author(s):  
Katharina Fleischhauer
Keyword(s):  
Malignant Disease ◽  
Hematopoietic Cell Transplantation ◽  
Donor Age ◽  
Nonmalignant Disease ◽  
Negative Effect ◽  
Unrelated Donors ◽  
Conventional Immunosuppression ◽  
Hla Mismatches ◽  
Selection Of

Abstract Matched unrelated donors (URD) are the most frequent source of stem cells for allogeneic hematopoietic cell transplantation (HCT) to date, with HCT performed mainly under conventional immunosuppression by methotrexate and cyclosporine. In this setting, every single allelic donor–recipient mismatch for HLA-A, -B, -C, -DRB1 (8/8), but not for HLA-DQB1, -DPB1, has a significant negative effect on overall survival (OS). When several 8/8 HLA-matched URD are available, donor age is the most important factor impacting OS. Moving forward from the traditional way of counting the number of donor–recipient HLA allele mismatches to biology-driven algorithms for functional matching has led to the unraveling of an association between permissive, low-risk HLA-DPB1 mismatches and improved outcome after URD HCT for malignant disease but not for nonmalignant disease. Functional HLA matching might prove to have increasing importance for URD selection in the era of new immunosuppressive regimens that have the potential to substantially reshuffle the role of HLA mismatches in URD HCT.

scholarly journals Clinical Relevance of HLA Supertype Matching after Myeloablative Conditioning 7/8 Unrelated Donor Hematopoietic Cell Transplantation: A CIBMTR Study

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2572-2572
Author(s):  
Aleksandr Lazaryan ◽  
Tao Wang ◽  
Stephen R. Spellman ◽  
Hai-Lin Wang ◽  
Carlheinz R. Müller ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hla Class I ◽  
Hematopoietic Cell ◽  
Class I ◽  
Unrelated Donor ◽  
Myeloablative Conditioning ◽  
Increased Risk ◽  
The Impact

Abstract The diversity of the HLA class I and II alleles can be simplified by consolidating them into fewer supertype clusters based on functional or predicted structural similarities in epitope binding grooves of HLA molecules. HLA class I and II supertypes have been increasingly studied in association with immune susceptibility to infection and cancer with potential implications for vaccine development. However, the significance of individual allele mismatching within and outside of HLA class I or II supertypes remains unknown in the context of hematopoietic cell transplantation (HCT). We therefore studied the impact of HLA supertype disparities on clinical outcomes of 1934 patients with AML (45%), ALL (31%), CML (14%) or MDS (9%) who underwent 7/8 unrelated donor myeloablative conditioning HCT from 1999 to 2011 and were registered with CIBMTR. Median age at transplant was 35 years (range, 1-70); 53% were males; 81% Caucasian; 56% received peripheral blood grafts; 50% were ABO-mismatched; 36% had in-vivo T-cell depletion; 62% received tacrolimus- and 36% cyclosporine A-based GVHD prophylaxis; 72% male or non-parous female donors; median follow up of survivors was 54 months (3-149). Supertype assignment methods of (1) revised main HLA anchor specificities (Sydney, 2008) and (2) bioinformatics (Doytchinova, 2004-05) were used to categorize single mismatched alleles into 6 HLA-A (A01, A01A03, A01A24, A02, A03, A24), 6 HLA-B (B07, B08, B27, B44, B58, B62), 2 HLA-C (C1, C2), and 5 DRB1 (DR1, DR3, DR4, DR5, DR9) supertypes. Overall survival (OS), disease-free survival (DFS), relapse, treatment-related mortality (TRM), acute graft vs. host disease (aGVHD) and chronic GVHD were compared across matched vs. mismatched HLA-A (265 vs. 429), -B (230 vs. 92), -C (365 vs. 349), and -DRB1 (153 vs. 51) supertypes. We used predetermined α=0.01 for statistical significance as multiple exploratory analyses were conducted by Kaplan-Meier, Gray, and Cox proportional hazard methods. In the multivariable analysis, supertype B-mismatch was associated with increased risk of grade II-IV aGVHD (HR=1.78; 95% CI, 1.23-2.59, p=0.0025), however no difference was found for grade III-IV aGVHD or other clinical outcomes compared to supertype B-matches. Supertype DRB1-mismatch was associated with shorter neutrophil recovery (HR=0.51; 95% CI, 0.36-0.71, p=0.0001), yet a trend toward inferior OS (HR=1.58; 95% CI 1.04-2.38, p=0.037) and higher TRM (HR=1.64; 95% CI, 0.99-2.74, p=0.0565) compared to DRB1 matches within supertypes. There was no increased risk of GVHD with DRB1 supertype mismatch. No associations were observed between HLA-A and -C supertypes or aggregate supertype-matched vs. -mismatched groups for any outcomes. Our analysis demonstrated differential influence of HLA supertype-based allele matching within -B and -DRB1 loci on clinical outcomes after myeloablative 7/8 URD HCT. Disclosures No relevant conflicts of interest to declare.

scholarly journals The effect of service quality and customer satisfaction toward customer loyalty in service industry

2021 ◽  
Vol 9 (3) ◽  
pp. 631-636 ◽  
Author(s):  
Dewi Dewi ◽  
Ferdian Hajadi ◽  
Yunita Wijaya Handranata ◽  
Maria Grace Herlina
Keyword(s):  
Customer Satisfaction ◽  
Service Quality ◽  
Customer Loyalty ◽  
Service Industry ◽  
Sampling Technique ◽  
Regression Methods ◽  
Positive Effects ◽  
The Impact ◽  
Positive Effect ◽  
Selection Of

The purpose of this study is to determine the impact of service quality and customer satisfaction on customer loyalty of the laundry service industry in Indonesia. The research methods used were quantitative, and analyzed using multiple linear regression methods. Data were obtained by distributing questionnaires to 100 respondents in Jakarta from February to March 2020. The selection of respondents used a purposive sampling technique, with the criteria of using laundry services in the past. Findings from this research revealed a significant positive effect of service quality toward customer satisfaction; and both service quality and customer satisfaction also have significant and positive effects towards customer loyalty in laundry services in Indonesia. From this research, it is expected that the entrepreneur in the laundry service industry would better understand the importance of service quality, customer satisfaction and its correlation to customer loyalty in order to improve firm sales performance.

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