title: Roles of HLA-B, HLA-C and HLA-DPA1 incompatibilities in the outcome of unrelated stem-cell transplantation.
abstract: In unrelated stem-cell transplantation, the value of matching at the HLA-A, -B and -DR loci between donor and recipient is well documented. The effect of HLA-C, DPB1 and DPA1 mismatches on transplantation outcome is unclear. In this study, 104 donor recipient-pairs, transplanted at Huddinge University Hospital between 1988 and 1999, were retrospectively HLA class I- and class II-typed by PCR-SSP. The samples were typed for HLA-A, -B and -C and HLA-DRB1, -DRB3, -DRB4, -DRB5, -DQA1, -DQB1, -DPB1 and -DPA1 with allele level resolution. Isolated HLA-B allele level mismatches were associated with an increased incidence of acute graft versus host disease grades II-IV and grades III-IV. HLA-C-mismatched, but killer cell immunoglobulin-like receptor (KIR) ligand motif-matched stem-cell grafts were significantly associated with improved survival rates and relapse-free survival (RFS). In patients receiving HLA-DPA1-mismatched stem cell grafts, reduced survival and shorter RFS were seen. These patients also had an increased frequency of relapses (64%vs 26%). We conclude that genomic HLA class I- and class II-typing may improve the outcome after unrelated stem-cell transplantation. The awareness of HLA class I- and II-mismatches in a recipient-donor pair makes it possible to give appropriate pre- and post-transplantation treatment.
authors.affiliation: Department of Biosciences at Novum, Karolinska Institutet at Huddinge University Hospital, Huddinge, Sweden. marie.schaffer@labmed.ki.se
authors.forename: M
authors.initials: M
authors.lastname: Schaffer
authors.forename: A
authors.initials: A
authors.lastname: Aldener-Cannavá
authors.forename: M
authors.initials: M
authors.lastname: Remberger
authors.forename: O
authors.initials: O
authors.lastname: Ringdén
authors.forename: O
authors.initials: O
authors.lastname: Olerup
mesh_terms: D000939:Epitopes; D006084:Graft Rejection / Q000235:genetics / Q000276:immunology*; D006086:Graft vs Host Disease / Q000235:genetics / Q000276:immunology; D015234:HLA-A Antigens / Q000276:immunology; D015235:HLA-B Antigens / Q000235:genetics / Q000276:immunology*; D015236:HLA-C Antigens / Q000235:genetics / Q000276:immunology*; D006682:HLA-DP Antigens / Q000235:genetics / Q000276:immunology*; D059867:HLA-DP alpha-Chains; D059868:HLA-DP beta-Chains; D006683:HLA-DQ Antigens / Q000276:immunology; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D008024:Ligands; D011971:Receptors, Immunologic / Q000235:genetics / Q000276:immunology; D033581:Stem Cell Transplantation; D013997:Time Factors
chemical_list: D000939:Epitopes; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D015236:HLA-C Antigens; D006682:HLA-DP Antigens; D059867:HLA-DP alpha-Chains; D059868:HLA-DP beta-Chains; C071172:HLA-DPA1 antigen; C071170:HLA-DPB1 antigen; D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens; D008024:Ligands; D011971:Receptors, Immunologic