Clinical and prognostic value of discrepancies in microsatellite DNA regions between recipient and donor in human leukocyte antigen-identical allogeneic transplantation setting.
BACKGROUND
Detection of recipient versus donor disparities in microsatellite DNA regions (short tandem repeats [STR]) allows for sensitive and specific monitorization of the degree of hematopoietic chimerism. It is well known that disparities between donor and recipient in various polymorphic systems (mainly human leukocyte antigen [HLA]) are associated with an increased incidence of graft-versus-host disease (GvHD). However, the possible biological role of STR discrepancies in GvHD development has not yet been well established.


METHODS
We evaluated 149 consecutive patients with hematologic malignancies receiving peripheral blood stem-cell transplantation from a human leukocyte antigen-identical sibling donor. A total of 15 STR regions were analyzed using the PowerPlex16 kit and classified as identical when recipient and donor share the same alleles, and mismatched when at least one of the alleles differed.


RESULTS
Higher severity of acute GvHD (II-IV, P=0.043) and shorter 5-year overall survival (P=0.016) was found in patients displaying more than 10 mismatches with respect to their donor. Additionally, higher risk of transplant-related mortality (P=0.019) was found in recipient-donor pairs with discrepancies in the D13S317 STR marker.


CONCLUSIONS
The present data suggest that genetic incompatibilities outside the human leukocyte antigen region between donors and recipients influence the outcome of patients receiving stem-cell transplantation. In addition, disparities in the neighboring D13S317 region could influence transplant-related mortality.
Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain.
Miguel
M
Alcoceba
Ana
A
Balanzategui
Maria
M
Díez-Campelo
Patricia
P
Martín-Jiménez
Maria Eugenia
ME
Sarasquete
M Carmen
MC
Chillón
Carlos
C
Santamaría
Jose Antonio
JA
Pérez-Simón
Luis
L
Marín
M Dolores
MD
Caballero
Jesús F
JF
San Miguel
Ramón
R
García-Sanz
Marcos
M
González
D004276:DNA, Satellite / Q000235:genetics*; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control; D006680:HLA Antigens / Q000235:genetics*; D019337:Hematologic Neoplasms / Q000235:genetics / Q000401:mortality / Q000601:surgery; D006801:Humans; D015994:Incidence; D018895:Microsatellite Repeats / Q000235:genetics*; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D017741:Survivors; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D004276:DNA, Satellite; D006680:HLA Antigens