Mismatch of minor histocompatibility antigen contributes to a graft-versus-leukemia effect rather than to acute GVHD, resulting in long-term survival after HLA-identical stem cell transplantation in Japan.
We determined the alleles of five polymorphic molecules including HA-1 and four adhesion molecules for 106 patients transplanted with HLA-identical stem cell grafts and investigated the association of mismatches as correlates of relapse and graft-versus-host disease (GVHD). All 106 recipients underwent stem cell transplantation (SCT) after myeloablative conditioning between 1985 and 2002. Risk status of disease at SCT was standard (n=63) and high (n=42). After SCT, 36, 49 and 33 developed acute GVHD, chronic GVHD and relapsed, respectively. Our patients relapsed at rates of 16.7 and 38.6% with one or more and without incompatibilities (P=0.013). The relapse rates of patients with CD62L, CD31 codon 563, CD31 codon 125, HA-1 and CD49b incompatibilities were 5.9, 11.8, 15.4, 16.0 and 33.3%, respectively. The frequency of acute GVHD did not differ regardless of incompatibilities. In standard-risk group, the accumulated relapse rates of 19 and 44 patients with and without minor histocompatibility antigen incompatibility were 22% and unexpectedly 66%, respectively (P=0.02). The probability of 12-year survival was 88% in the former and 66% in the latter patients (P=0.03). Our data suggest that incompatibility of CD62L, CD31 codon 563 and CD31 codon 125 contributes to a graft-versus-leukemia effect rather than to GVHD, resulting in prolonged survival after HLA-identical SCT.
Katagiri
T
T
Faculty of Health Science, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa City 920-8641, Japan.
Shiobara
S
S
Nakao
S
S
Wakano
M
M
Muranaka
E
E
Kuba
N
N
Furukawa
T
T
Tsukada
J
J
Takeda
H
H
Aizawa
Y
Y
Harada
M
M
D000208:Acute Disease; D001483:Base Sequence; D017931:DNA Primers / Q000235:genetics; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D020544:Graft vs Leukemia Effect / Q000276:immunology*; D006680:HLA Antigens; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007938:Leukemia / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D008297:Male; D015778:Minor Histocompatibility Antigens / Q000235:genetics; D012008:Recurrence; D033581:Stem Cell Transplantation; D015996:Survival Rate
D017931:DNA Primers; D006680:HLA Antigens; D015778:Minor Histocompatibility Antigens