Faculty Collaboration Database

Assessment of Impact of HLA Type on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia. Biol Blood Marrow Transplant 2018 Mar;24(3):581-586

Date

10/17/2017

Pubmed ID

29032274

Pubmed Central ID

PMC5944847

DOI

10.1016/j.bbmt.2017.10.015

Scopus ID

2-s2.0-85041598291 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Chronic lymphocytic leukemia (CLL) is a common hematologic malignancy with many highly effective therapies. Chemorefractory disease, often characterized by deletion of chromosome 17p, has historically been associated with very poor outcomes, leading to the application of allogeneic hematopoietic stem cell transplantation (allo-HCT) for medically fit patients. Although the use of allo-HCT has declined since the introduction of novel targeted therapy for the treatment of CLL, there remains significant interest in understanding factors that may influence the efficacy of allo-HCT, the only known curative treatment for CLL. The potential benefit of transplantation is most likely due to the presence of alloreactive donor T cells that mediate the graft-versus-leukemia (GVL) effect. The recognition of potentially tumor-specific antigens in the context of class I and II major histocompatibility complex on malignant B lymphocytes by donor T cells may be influenced by subtle differences in the highly polymorphic HLA locus. Given previous reports of specific HLA alleles impacting the incidence of CLL and the clinical outcomes of allo-HCT for CLL, we sought to study the overall survival and progression-free survival of a large cohort of patients with CLL who underwent allo-HCT from fully HLA-matched related and unrelated donors at Center for International Blood and Marrow Transplant Research transplantation centers. We found no statistically significant association of allo-HCT outcomes in CLL based on previously reported HLA combinations. Additional study is needed to further define the immunologic features that portend a more favorable GVL effect after allo-HCT for CLL.

Author List

Hill BT, Ahn KW, Hu ZH, Aljurf M, Beitinjaneh A, Cahn JY, Cerny J, Kharfan-Dabaja MA, Ganguly S, Ghosh N, Grunwald MR, Inamoto Y, Kindwall-Keller T, Nishihori T, Olsson RF, Saad A, Seftel M, Seo S, Szer J, Tallman M, Ustun C, Wiernik PH, Maziarz RT, Kalaycio M, Alyea E, Popat U, Sobecks R, Saber W

Authors

Kwang Woo Ahn PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Wael Saber MD, MS Professor in the Medicine department at Medical College of Wisconsin

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

Adolescent
Adult
Aged
Allografts
Disease-Free Survival
Female
HLA Antigens
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Leukemia, Lymphocytic, Chronic, B-Cell
Male
Middle Aged
Survival Rate