Faculty Collaboration Database

Multiple mismatches at the low expression HLA loci DP, DQ, and DRB3/4/5 associate with adverse outcomes in hematopoietic stem cell transplantation. Blood 2013 May 30;121(22):4603-10

Date

04/19/2013

Pubmed ID

23596045

Pubmed Central ID

PMC3668493

DOI

10.1182/blood-2013-02-481945

Scopus ID

2-s2.0-84880775816 (requires institutional sign-in at Scopus site)   123 Citations

Abstract

A single mismatch in highly expressed HLA-A, -B, -C, and -DRB1 loci (HEL) is associated with worse outcomes in hematopoietic stem cell transplantation, while less is known about the cumulative impact of mismatches in the lesser expressed HLA loci DRB3/4/5, DQ, and DP (LEL). We studied whether accumulation of LEL mismatches is associated with deleterious effects in 3853 unrelated donor transplants stratified according to number of matches in the HEL. In the 8/8 matched HEL group, LEL mismatches were not associated with any adverse outcome. Mismatches at HLA-DRB1 were associated with occurrence of multiple LEL mismatches. In the 7/8 HEL group, patients with 3 or more LEL mismatches scored in the graft-versus-host vector had a significantly higher risk of mortality (1.45 and 1.43) and transplant-related mortality (1.68 and 1.54) than the subgroups with 0 or 1 LEL mismatches. No single LEL locus had a more pronounced effect on clinical outcome. Three or more LEL mismatches are associated with lower survival after 7/8 HEL matched transplantation. Prospective evaluation of matching for HLA-DRB3/4/5, -DQ, and -DP loci is warranted to reduce posttransplant risks in donor-recipient pairs matched for 7/8 HEL.

Author List

Fernández-Viña MA, Klein JP, Haagenson M, Spellman SR, Anasetti C, Noreen H, Baxter-Lowe LA, Cano P, Flomenberg N, Confer DL, Horowitz MM, Oudshoorn M, Petersdorf EW, Setterholm M, Champlin R, Lee SJ, de Lima M

Author

Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Female
Graft Rejection
HLA-DP Antigens
HLA-DQ Antigens
HLA-DR beta-Chains
HLA-DRB3 Chains
HLA-DRB4 Chains
HLA-DRB5 Chains
Hematopoietic Stem Cell Transplantation
Histocompatibility
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Risk Factors
Tissue Donors
Young Adult