Hla-DPB1 mismatch in HLA-A-B-DRB1 identical sibling donor stem cell transplantation and acute graft-versus-host disease.
BACKGROUND
The role of human leukocyte antigen (HLA)-DPB1 as a transplantation antigen is controversial. A higher incidence of acute graft-versus-host disease (aGVHD) has been described after unrelated donor bone marrow transplant when both HLA-DPB1 alleles were mismatched.


METHODS
We investigated the impact of a single HLA-DPB1 mismatch after HLA-A-B-DRB1 identical sibling donor transplantation on aGVHD. We analyzed 627 adult patient-donor pairs and identified 30 pairs without HLA-DPB1 identity (4.78%). In 17 cases, the patient had an allele that was not shared by the donor.


RESULTS
The cumulative incidence of grades II-IV aGVHD was higher in the HLA-DPB1 mismatched group (66.7% vs. 35.7%, p=0.012). The HLA-DPB1 mismatch was identified by multivariate analysis as an independent risk factor for aGVHD (p=0.020, RR=2.68, 95% CI: 1.73-3.62).


CONCLUSIONS
HLA-DPB1 can mediate alloreactive responses. A single HLA-DPB1 mismatch increases the risk of aGVHD after sibling donor stem cell transplantation.
Gallardo
David
D
Alloreactivity Unit of the Institut Català d'Oncologia, Barcelona, Spain. 27532dgg@comb.es
Brunet
Salut
S
Torres
Antonio
A
Alonso-Nieto
Manuela
M
Vallejo
Carlos
C
Jiménez
Antonio
A
González
Marcos
M
Sanz
Guillermo
G
Serrano
David
D
Espigado
Ildefonso
I
Osorio
Santiago
S
Carreras
Enric
E
Martiín
Carmen
C
Sanz-Rodríguez
César
C
Sierra
Jorge
J
Zuazu
Javier
J
González-Escribano
M Francisca
MF
González
Juan R
JR
Román
José
J
De Oteyza
Jaime Pérez
JP
De La Cámara
Rafael
R
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology*; D015234:HLA-A Antigens / Q000276:immunology*; D015235:HLA-B Antigens / Q000276:immunology*; D006682:HLA-DP Antigens / Q000276:immunology*; D059868:HLA-DP beta-Chains; D006684:HLA-DR Antigens / Q000276:immunology*; D059811:HLA-DRB1 Chains; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014019:Tissue Donors
D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006682:HLA-DP Antigens; D059868:HLA-DP beta-Chains; C071170:HLA-DPB1 antigen; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains