title: The potential role of HLA-DRB1*11 in the development and outcome of haematopoietic stem cell transplantation-associated thrombotic microangiopathy.
abstract: Transplantation-associated thrombotic microangiopathy (TA-TMA) is a serious complication of allogeneic haematopoietic stem cell transplantation (allo-HSCT) with high mortality rate. We retrospectively studied the frequency, clinical and genetic associations and prognostic effect of TA-TMA, in a total of 425 consecutive adult patients, who underwent allo-HSCT for a malignant haematological condition between 2007 and 2013 at our single centre. TA-TMA developed in 19% of the patients. Unrelated donor type (P<0.001), acute GvHD grades II-IV (P<0.001), myeloablative conditioning regimens (P=0.003), tacrolimus-based GvHD prophylaxis (P=0.003), CMV infection (P=0.003) and carriership for HLA-DRB1*11 (P=0.034) were associated with the development of TA-TMA. Survival was adversely affected by the presence of TA-TMA (P<0.001). Among patients with TA-TMA, the outcome of HLA-DRB1*11 carriers was significantly better compared with non-carriers (P=0.003). As a new finding, our observations suggest that the presence of HLA-DRB1*11 antigen contributes to the development of TA-TMA and affects the outcome.
authors.affiliation: Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.
authors.forename: K
authors.initials: K
authors.lastname: Balassa
authors.affiliation: Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.
authors.forename: H
authors.initials: H
authors.lastname: Andrikovics
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. Istvan and St. Laszlo Hospital, Budapest, Hungary.
authors.forename: P
authors.initials: P
authors.lastname: Remenyi
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. Istvan and St. Laszlo Hospital, Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Batai
authors.affiliation: Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Bors
authors.affiliation: Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.
authors.forename: K P
authors.initials: KP
authors.lastname: Kiss
authors.affiliation: Transplantation Immunogenetics Laboratory, Hungarian National Blood Transfusion Service, Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Szilvasi
authors.affiliation: Hungarian Stem Cell Donor Registry, Hungarian National Blood Transfusion Service, Budapest, Hungary.
authors.forename: K
authors.initials: K
authors.lastname: Rajczy
authors.affiliation: Transplantation Immunogenetics Laboratory, Hungarian National Blood Transfusion Service, Budapest, Hungary.
authors.forename: D
authors.initials: D
authors.lastname: Inotai
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. Istvan and St. Laszlo Hospital, Budapest, Hungary.
authors.forename: L
authors.initials: L
authors.lastname: Gopcsa
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. Istvan and St. Laszlo Hospital, Budapest, Hungary.
authors.forename: L
authors.initials: L
authors.lastname: Lengyel
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. Istvan and St. Laszlo Hospital, Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Barta
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. Istvan and St. Laszlo Hospital, Budapest, Hungary.
authors.forename: M
authors.initials: M
authors.lastname: Reti
authors.affiliation: Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Tordai
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. Istvan and St. Laszlo Hospital, Budapest, Hungary.|3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Masszi
mesh_terms: D005260:Female; D059811:HLA-DRB1 Chains / Q000276:immunology / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D057049:Thrombotic Microangiopathies / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
chemical_list: D059811:HLA-DRB1 Chains; C508422:HLA-DRB1*11 antigen