title: HLA DR15 antigen status does not impact graft-versus-host disease or survival in HLA-matched sibling transplantation for hematologic malignancies.
abstract: The HLA class II DRB1 antigen DR15 is an important prognostic marker in immune-mediated marrow failure states. DR15 has also been associated with favorable outcomes (reduced acute graft-versus-host disease [aGVHD] and relapse) after allogeneic hematopoietic cell transplant. To elucidate the impact of DR15 on transplantation outcomes, we conducted a retrospective study of 2891 recipients of first allogeneic stem cell transplant from HLA-matched sibling donors for the treatment of acute leukemia, chronic myeloid leukemia, or myelodysplastic syndrome (MDS) between 1990 and 2007. All patients received conventional myeloablative conditioning, T-replete grafts, and cyclosporine plus methotrexate-based GVHD prophylaxis. DNA-based HLA typing allowed categorization of 732 patients (25.3%) as positive and 2159 patients (74.7%) as negative for DRB1*15:01 or *15:02 (DR15). There were no significant differences in baseline characteristics between the HLA DR15 positive and negative groups. In univariate analysis, HLA-DR15 status had no impact on neutrophil engraftment, aGVHD, chronic GVHD (cGVHD), treatment-related mortality, relapse, disease-free survival, or overall survival (OS). In multivariate analysis, DR15 status showed no significant difference in aGVHD, cGVHD, OS, or relapse. In conclusion, DR15 status had no impact on major HLA-matched sibling donor hematopoietic cell transplant outcomes in this large and homogenous cohort of patients with leukemia and MDS.
authors.affiliation: National Heart Lung and Blood Institute, National Institute of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA. minoo.battiwalla@nih.gov
authors.forename: Minoo
authors.initials: M
authors.lastname: Battiwalla
authors.forename: Kristin
authors.initials: K
authors.lastname: Ellis
authors.forename: Peigang
authors.initials: P
authors.lastname: Li
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: Pavletic
authors.forename: Gorgun
authors.initials: G
authors.lastname: Akpek
authors.forename: Peiman
authors.initials: P
authors.lastname: Hematti
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Klumpp
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.forename: Bipin N
authors.initials: BN
authors.lastname: Savani
authors.forename: Mahmoud D
authors.initials: MD
authors.lastname: Aljurf
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Cairo
authors.forename: William R
authors.initials: WR
authors.lastname: Drobyski
authors.forename: Biju
authors.initials: B
authors.lastname: George
authors.forename: Theresa
authors.initials: T
authors.lastname: Hahn
authors.forename: Nandita
authors.initials: N
authors.lastname: Khera
authors.forename: Mark R
authors.initials: MR
authors.lastname: Litzow
authors.forename: Alison W
authors.initials: AW
authors.lastname: Loren
authors.forename: Wael
authors.initials: W
authors.lastname: Saber
authors.forename: Mukta
authors.initials: M
authors.lastname: Arora
authors.forename: Alvaro
authors.initials: A
authors.lastname: Urbano-Ispizua
authors.forename: Corey
authors.initials: C
authors.lastname: Cutler
authors.forename: Mary E D
authors.initials: ME
authors.lastname: Flowers
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Spellman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology*; D059810:HLA-DR Serological Subtypes / Q000276:immunology*; D019337:Hematologic Neoplasms / Q000276:immunology* / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006648:Histocompatibility / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D035781:Siblings; D016019:Survival Analysis; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D059810:HLA-DR Serological Subtypes; C106559:HLA-DR15 antigen