title: Hla-DPB1 mismatch in HLA-A-B-DRB1 identical sibling donor stem cell transplantation and acute graft-versus-host disease.
abstract: 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.
authors.affiliation: Alloreactivity Unit of the Institut Català d'Oncologia, Barcelona, Spain. 27532dgg@comb.es
authors.forename: David
authors.initials: D
authors.lastname: Gallardo
authors.forename: Salut
authors.initials: S
authors.lastname: Brunet
authors.forename: Antonio
authors.initials: A
authors.lastname: Torres
authors.forename: Manuela
authors.initials: M
authors.lastname: Alonso-Nieto
authors.forename: Carlos
authors.initials: C
authors.lastname: Vallejo
authors.forename: Antonio
authors.initials: A
authors.lastname: Jiménez
authors.forename: Marcos
authors.initials: M
authors.lastname: González
authors.forename: Guillermo
authors.initials: G
authors.lastname: Sanz
authors.forename: David
authors.initials: D
authors.lastname: Serrano
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Espigado
authors.forename: Santiago
authors.initials: S
authors.lastname: Osorio
authors.forename: Enric
authors.initials: E
authors.lastname: Carreras
authors.forename: Carmen
authors.initials: C
authors.lastname: Martiín
authors.forename: César
authors.initials: C
authors.lastname: Sanz-Rodríguez
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.forename: Javier
authors.initials: J
authors.lastname: Zuazu
authors.forename: M Francisca
authors.initials: MF
authors.lastname: González-Escribano
authors.forename: Juan R
authors.initials: JR
authors.lastname: González
authors.forename: José
authors.initials: J
authors.lastname: Román
authors.forename: Jaime Pérez
authors.initials: JP
authors.lastname: De Oteyza
authors.forename: Rafael
authors.initials: R
authors.lastname: De La Cámara
mesh_terms: 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
chemical_list: 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