Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8737697 | Human Immunology | 2018 | 7 Pages |
Abstract
The role of HLA system in allogeneic haematopoietic stem cell transplantation (allo-HSCT) outcome is unarguable. In this study we investigated association of HLA-A,-B and-DRB1 alleles with overall survival (OS) in 186 patients undergoing allo-HSCT for lymphoid malignancies. Analyses confirmed significantly better OS for HLA-DRB1â04 carriers compared with non-carriers (pâ¯=â¯0.01). Survival benefit was confined to male patients (in multivariate analyses pâ¯=â¯0.034, hazard ratio 0.35, 95% confidence interval 0.13-0.92), whereas in females no difference was noted (pâ¯=â¯0.82). Furthermore, donor gender also affected outcome and transplantation from female HLA-DRB1â04 carrier donors resulted in superior survival compared with female non-carrier donors (pâ¯=â¯0.01). Combined analyses including recipient/donor gender and HLA-DRB1â04 showed that survival of male patients varied significantly according to donor gender and HLA-DRB1â04 carriership (pâ¯=â¯0.04) with best survival among HLA-DRB1â04 carriers transplanted from female donors. Of relevance to our results, HLA-DRB1â04 has been documented as risk allele group for lymphoid malignancies, and studies described a male-specific risk. We believe that our findings provide further supporting evidence for sex-specific alterations secondary to HLA-DRB1â04 or related genes. Further studies are warranted to evaluate whether in contrast to general favour of male donors HLA-DRB1â04 carrier patients with lymphoid malignancies could benefit from transplantation from female donors.
Keywords
RICNHLCLLTACTRMGvHDAllogeneic HSCThuman leucocyte antigenHLAprobability valueAllo-HSCTEBVCSALymphoid malignancySurvivaloverall survivalGraft-versus-host diseaseTacrolimusMyeloablative conditioningcomplete remissioncytomegalovirusCMVCyclosporineconfidence intervalNon-Hodgkin’s lymphomaHodgkin lymphomaAcute lymphoid leukaemiamajor histocompatibility complexMHCTransplantation-related mortalityMultiple myelomaMAChazard ratioALLEpstein-Barr virusAllogeneic haematopoietic stem cell transplantationreduced intensity conditioning
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Authors
Katalin Balassa, Hajnalka Andrikovics, Peter Remenyi, Arpad Batai, Aniko Szilvasi, Andras Bors, Katalin Piroska Kiss, Katalin Rajczy, Dora Inotai, Eva Torbagyi, Lilla Lengyel, Aniko Barta, Laszlo Gopcsa, Attila Tordai, Tamas Masszi,