title: Haploidentical hematopoietic stem cell transplantation for lymphoma with monosomy of chromosome 6 (loss of heterozygosity in the HLA region)--who should be a donor?
abstract: Hematopoietic stem cell transplantation (HSCT) from an HLA haploidentical family donor is an option for patients who do not have a full HLA matched donor and lack the time to find an unrelated one [1,2]. Furthermore, it may facilitate a powerful graft versus leukemia/lymphoma (GVL) effect to help combat hematological malignancies by directly targeting the mismatched HLA expressed on leukemia/lymphoma cells [3]. On the contrary, leukemia/lymphoma cells escape from the surveillance of the donor-derived GVL effect by losing the target HLA (mismatched HLA in GVH direction). This mechanism has been called loss of heterozygosity (LOH) in the HLA gene region on chromosome 6 [4,5]. Taking the above into account, in this case report, we present a case of lymphoma with monosomy 6, which means natural LOH of HLA, and suggest that selection of a haploidentical family donor matched with the missing HLA haplotype seems to be very effective.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan. kame@hyo-med.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ikegame
authors.forename: Katsuji
authors.initials: K
authors.lastname: Kaida
authors.forename: Leif
authors.initials: L
authors.lastname: Lakoma
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ishii
authors.forename: Takayuki
authors.initials: T
authors.lastname: Inoue
authors.forename: Ruri
authors.initials: R
authors.lastname: Kato
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Soma
authors.forename: Masaya
authors.initials: M
authors.lastname: Okada
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D002896:Chromosomes, Human, Pair 6 / Q000235:genetics*; D005260:Female; D020350:Graft vs Tumor Effect / Q000235:genetics / Q000276:immunology; D006680:HLA Antigens / Q000235:genetics*; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D019656:Loss of Heterozygosity; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics / Q000276:immunology* / Q000628:therapy*; D008297:Male; D009006:Monosomy; D010375:Pedigree; D012074:Remission Induction; D014019:Tissue Donors
chemical_list: D006680:HLA Antigens