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Role of HLA-DP Expression in Graft-Versus-Host Disease After Unrelated Donor Transplantation.
Petersdorf, Effie W; Bengtsson, Mats; De Santis, Dianne; Dubois, Valerie; Fleischhauer, Katharina; Gooley, Ted; Horowitz, Mary; Madrigal, J Alejandro; Malkki, Mari; McKallor, Caroline; Morishima, Yasuo; Oudshoorn, Machteld; Spellman, Stephen R; Villard, Jean; Stevenson, Phil; Carrington, Mary.
Afiliación
  • Petersdorf EW; Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.
  • Bengtsson M; Department of Medicine, University of Washington, Seattle, WA.
  • De Santis D; Department of Immunology, Genetics, and Pathology, University of Uppsala, Uppsala, Sweden.
  • Dubois V; PathWest, Fiona Stanley Hospital, Perth, WA, Australia.
  • Fleischhauer K; Etablissement Français du Sang Auvergne Rhône Alpes, site de Lyon, Décines, France.
  • Gooley T; Institute for Experimental Cellular Therapy, University of Duisburg-Essen, Essen, Germany.
  • Horowitz M; Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.
  • Madrigal JA; Center for International Blood and Marrow Transplant Research, Milwaukee, WI.
  • Malkki M; Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI.
  • McKallor C; Anthony Nolan Research Institute, Royal Free Hospital, London, United Kingdom.
  • Morishima Y; Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.
  • Oudshoorn M; Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.
  • Spellman SR; Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
  • Villard J; Leiden University Medical Centre, Department Immunohematology and Blood Transfusion, Leiden, the Netherlands.
  • Stevenson P; Matchis Foundation, Leiden, the Netherlands.
  • Carrington M; Center for International Blood and Marrow Transplant Research, Minneapolis, MN.
J Clin Oncol ; 38(24): 2712-2718, 2020 08 20.
Article en En | MEDLINE | ID: mdl-32479188
ABSTRACT

PURPOSE:

The main aim of this study was to evaluate the significance of HLA-DPB1 expression in acute graft-versus-host disease (GVHD) after hematopoietic cell transplantation (HCT) from HLA-A, -B, -C, -DRB1, -DQB1-matched and -mismatched unrelated donors. PATIENTS AND

METHODS:

Between January 1, 2017, and January 10, 2019, we assessed 19,136 patients who received HCT from an HLA-A, -B, -C, -DRB1, -DQB1-matched or -mismatched unrelated donor performed in Australia, the European Union, Japan, North America, and the United Kingdom between 1988 and 2016. Among transplant recipients with one HLA-DPB1 mismatch, the patient's mismatched HLA-DPB1 allotype was defined as low or high expression. Multivariable regression models were used to assess risks of GVHD associated with high expression relative to low expression HLA-DPB1 mismatches. The effect of increasing numbers of HLA-DPB1 mismatches on clinical outcome was assessed in HLA-mismatched transplant recipients.

RESULTS:

In HLA-A, -B, -C, -DRB1,-DQB1-matched transplant recipients, donor mismatching against one high-expression patient HLA-DPB1 increased moderate (odds ratio [OR], 1.36; P = .001) and severe acute GVHD (OR, 1.32; P = .0016) relative to low-expression patient mismatches, regardless of the expression level of the donor's mismatched HLA-DPB1. Among transplant recipients with one HLA-A, -B, -C, -DRB1, or -DQB1 mismatch, the odds of acute GVHD increased with increasing numbers of HLA-DPB1 mismatches (OR, 1.23 for one; OR, 1.40 for two mismatches relative to zero mismatches for moderate GVHD; OR, 1.19 for one; OR, 1.40 for two mismatches relative to zero for severe GVHD), but not with the level of expression of the patient's mismatched HLA-DPB1 allotype.

CONCLUSION:

The level of expression of patient HLA-DPB1 mismatches informs the risk of GVHD after HLA-A, -B, -C, -DRB1, -DQB1-matched unrelated HCT, and the total number of HLA-DPB1 mismatches informs the risk of GVHD after HLA-mismatched unrelated HCT. Prospective consideration of HLA-DPB1 may help to lower GVHD risks after transplantation.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Antígenos HLA-DP / Trasplante de Células Madre Hematopoyéticas / Acondicionamiento Pretrasplante / Donante no Emparentado / Enfermedad Injerto contra Huésped Límite: Female / Humans / Male Idioma: En Revista: J Clin Oncol Año: 2020 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Antígenos HLA-DP / Trasplante de Células Madre Hematopoyéticas / Acondicionamiento Pretrasplante / Donante no Emparentado / Enfermedad Injerto contra Huésped Límite: Female / Humans / Male Idioma: En Revista: J Clin Oncol Año: 2020 Tipo del documento: Article