Association of human leukocyte antigen class II alleles with response to immunosuppressive therapy in Korean aplastic anemia patients.
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.
Song
Eun Young
EY
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
Kang
Hyoung Jin
HJ
Shin
Hee Young
HY
Ahn
Hyo Seop
HS
Kim
Inho
I
Yoon
Sung-Soo
SS
Park
Seonyang
S
Kim
Byoung Kook
BK
Park
Myoung Hee
MH
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
D000961:Antilymphocyte Serum; D006681:HLA-D Antigens; D007166:Immunosuppressive Agents; D016572:Cyclosporine