title: Association of human leukocyte antigen class II alleles with response to immunosuppressive therapy in Korean aplastic anemia patients.
abstract: HLA-DR15 (DR2) is overrepresented in aplastic anemia (AA) patients, and its presence is associated with a better response to cyclosporine-based immunosuppressive therapy (IST). However, little is known about other human leukocyte antigen (HLA) alleles affecting therapy response. We investigated 37 Korean patients with severe AA for the association of HLA class II alleles with response to IST: cyclosporine A combined with antithymocyte globulin or antilymphocyte globulin. Molecular or serologic typing of HLA-DR and HLA-DQ alleles was performed. In responders (13/37, 35.1%), the frequency of HLA-DR15 was increased (69.2% vs 8.3%, p = 0.0002) and that of DR4 was decreased (7.7% vs 66.7%, p = 0.0007) compared with nonresponders. The response rate was significantly higher in DR15(+) than in DR15(-) (81.8% vs 15.4%, p = 0.0002) and in DR4(-) than in DR4(+) patients (60.0% vs 5.9%, p = 0.0007). The response rates in the best (DR15(+)/DR4(-)), intermediate, and poor response groups (DR15(-)/DR4(+)) were 88.9, 38.5, and 0%, respectively (p = 0.00001). At the allelic level, DRB1*1501 and closely linked DQB1*0602 were associated with a good response and DRB1*0405 and closely linked DQB1*0401 with a poor response to IST. HLA-DR typing may be useful for predicting a response to IST in AA patients.
authors.affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Song
authors.forename: Hyoung Jin
authors.initials: HJ
authors.lastname: Kang
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Shin
authors.forename: Hyo Seop
authors.initials: HS
authors.lastname: Ahn
authors.forename: Inho
authors.initials: I
authors.lastname: Kim
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Yoon
authors.forename: Seonyang
authors.initials: S
authors.lastname: Park
authors.forename: Byoung Kook
authors.initials: BK
authors.lastname: Kim
authors.forename: Myoung Hee
authors.initials: MH
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D000741:Anemia, Aplastic / Q000188:drug therapy / Q000235:genetics* / Q000276:immunology*; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D044466:Asian People / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006681:HLA-D Antigens / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D006681:HLA-D Antigens; D007166:Immunosuppressive Agents; D016572:Cyclosporine