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The degree of matching at HLA-DPB1 predicts for acute graft-versus-host disease and disease relapse following haematopoietic stem cell transplantation. Bone Marrow Transplant 2003 Jun;31(11):1001-8

Date

05/30/2003

Pubmed ID

12774051

DOI

10.1038/sj.bmt.1704029

Scopus ID

2-s2.0-0038686000 (requires institutional sign-in at Scopus site)   52 Citations

Abstract

The importance of matching for HLA-DPB1 in unrelated donor haematopoietic stem cell (HSC) transplantation is little understood. Most transplant centres do not, currently, prospectively match for DPB1, but emerging data show that DPB1 matching does play a role in determining outcome. We studied the impact of HLA-DPB1 matching on outcome in 143 recipients of T-cell depletion transplants, who matched with their respective unrelated donors (allelic level) at HLA-A, -B, -C, -DRB1 and -DQB1. Of those matched at DPB1, 47.2% (17/36) developed acute graft-versus-host disease (aGvHD) as compared to 66.3% (55/83) of those who were mismatched. This led to a 19.1% (95% CI 0.1-38.3%) increase in the chance of developing aGvHD in mismatched patients (P=0.049). Relapse of the original disease occurred in 51 recipients; 23 of 37 (62%) matched at both DPB1 alleles, 28 of 82 (34%) were mismatched at one or two DPB1 alleles. Thus, there was a significantly higher relapse rate (P=0.0011) in transplant recipients who matched at both DPB1 alleles. In conclusion, a donor/recipient DPB1 match was associated with a significantly lower incidence of aGvHD and a significantly higher incidence of disease relapse. This study provides further evidence for an immunogenic role of HLA-DPB1 in HSC transplants.

Author List

Shaw BE, Potter MN, Mayor NP, Pay AL, Smith C, Goldman JM, Prentice HG, Marsh SG, Madrigal JA

Author

Bronwen E. Shaw MBChB, PhD Center Director, Professor in the Medicine department at Medical College of Wisconsin




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

Acute Disease
Adolescent
Adult
Child
Child, Preschool
Cytomegalovirus Infections
Female
Graft vs Host Disease
HLA-DP Antigens
HLA-DP beta-Chains
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Infant
Leukemia
Lymphocyte Depletion
Male
Middle Aged
Parity
Predictive Value of Tests
Probability
Recurrence
Survival Rate
T-Lymphocytes
Time Factors