Faculty Collaboration Database

The importance of HLA-DPB1 in unrelated donor hematopoietic cell transplantation. Blood 2007 Dec 15;110(13):4560-6

Date

08/30/2007

Pubmed ID

17726164

DOI

10.1182/blood-2007-06-095265

Scopus ID

2-s2.0-38349017549 (requires institutional sign-in at Scopus site)   158 Citations

Abstract

Hematopoietic cell transplantation (HCT) from an HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 allele-matched unrelated donor is a well-recognized life-saving treatment modality for patients with hematologic disorders. The morbidity and mortality from clinically significant acute graft-versus-host disease (aGVHD) remains a limitation. The extent to which transplantation outcome may be improved with donor matching for HLA-DP is not well defined. The risks of aGVHD, relapse, and mortality associated with HLA-DPB1 allele mismatching were determined in 5929 patients who received a myeloablative HCT from an HLA-A-, HLA-B-, HLA-C-, HLA-DRB1-, and HLA-DQB1-matched or -mismatched donor. There was a statistically significantly higher risk of both grades 2 to 4 aGVHD (odds ratio [OR] = 1.33; P < .001) and grades 3 to 4 aGVHD (OR = 1.26; P < .001) after HCT from an HLA-DPB1-mismatched donor compared with a matched donor. The increased risk of aGVHD was accompanied by a statistically significantly decrease in disease relapse (hazard ratio [HR] = 0.82; P = .01). HLA-DPB1 functions as a classical transplantation antigen. The increased risk of GVHD associated with HLA-DPB1 mismatching is accompanied by a lower risk of relapse. Knowledge of the DPB1 matching status prior to transplantation will aid in more precise risk stratification for the individual patient.

Author List

Shaw BE, Gooley TA, Malkki M, Madrigal JA, Begovich AB, Horowitz MM, Gratwohl A, Ringdén O, Marsh SG, Petersdorf EW

Authors

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

Adolescent
Adult
Aged
Alleles
Child
Child, Preschool
Epidemiologic Measurements
Female
Graft vs Host Disease
HLA-DP Antigens
HLA-DP beta-Chains
Hematopoietic Stem Cell Transplantation
Histocompatibility
Histocompatibility Testing
Humans
Infant
Male
Middle Aged
Odds Ratio
Recurrence
Risk
Survival Rate
Tissue Donors
Treatment Outcome