HLA-DPB1 matching status has significant implications for recipients of unrelated donor stem cell transplants

Abstract

Studies in unrelated donor (UD) hematopoietic stem cell transplantations (HSCT)show an effect of the matching status of HLA-DPB1 on complications. We analyzed 423 UD-HSCT pairs. Most protocols included T-cell depletion (TCD). All pairs had high-resolution tissue typing performed for 6 HLA loci. Two hundred eightytwo pairs were matched at 10 of 10 alleles (29% were DPB1 matched). In 141 HLAmismatched pairs, 28% were matched for DPB1. In the 10 of 10 matched pairs (n ‫؍‬ 282), the 3-year probability of relapse was 61%. This was significantly higher in DPB1-matched pairs (74%) as compared with DPB1-mismatched pairs (56%) (log rank, P ‫؍‬ .001). This finding persisted in multivariate analysis. In the group overall (n ‫؍‬ 423), relapse was also significantly increased if DPB1 was matched (log rank; P < .001). These results were similar in chronic myeloid leukemia (CML; P < .001) and acute lymphoblastic leukemia (ALL; P ‫؍‬ .013). In ALL, DPB1-matched pairs had a significantly worse overall survival (log rank; P ‫؍‬ .025).Thus, in recipients of TCD UD-HSCT, a match for DPB1 is associated with a significantly increased risk of disease relapse, irrespective of the matching status for the other HLA molecules. It is possible that this effect is especially apparent following TCD transplantations and invites speculation about the function of DPB1 within the immune system. (Blood. 2006; 107:1220-1226)

Impact of HLA-DPB1 Matching in Unrelated Allogeneic Stem Cell Transplantation: Results of Two Centers From Turkey

“…Another article, that is published by Shaw et al, reported a higher relapse rate in HLA-DPB1-matched pairs as compared with HLA-DPB1-mismatched pairs in a group of 10/10 matched T-cell depleted unrelated ASCTs. 14 In this study, researchers observed a higher rate of aG-VHD, without a difference in TRM or OS in HLA-DPB1 mismatched transplantations. Fleischhauer et al reported an increased risk of graft failure with the presence of nonpermissive HLA-DPB1 mismatches, in a group of unrelated ASCT for betathalassemia patients.…”

“…[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] For instance, in the study by Loiseau et al reported increased frequency of severe aGVHD and poorer survival in two HLA-DP incompatibilities in a group of unrelated ASCT patients. 10 In this study they were not able show a significant relationship between HLA-DP mismatches and disease relapse.…”

Strategies of the donor search for children with second CR ALL lacking a matched sibling donor

“…Conflicting results have been reported on the relative importance of various class I and II loci mismatches on outcome. [21][22][23][24][25][26][27][28] Early studies reported that low-resolution mismatches at HLA-A and -B Ags, and high-resolution mismatches at HLA-DRB1 allele are associated with worse GvHD and survival. [21][22] Matching algorithms favoured class II matching over class I matching when a complete match could not be found.…”

“…Statistically, relapse was significantly higher among HLA-DPB1-matched patients (74%) as compared with HLA-DPB1-mismatched patients (56%, P ¼ 0.001). 28 A large National Marrow Donor Program (NMDP) study reported that single low-resolution mismatches for both class I (including HLA-C) and for DRB1 loci are independently associated with a significantly higher risk of graft rejection, GvHD and mortality, as compared with full matching. This observation suggests that HLA-C typing should be included in search algorithms.…”

Topical issues in unrelated donor haematopoietic stem cell transplants: a report from a workshop convened by the Anthony Nolan Trust in London – 2005

“…Bronwen Shaw began by providing a summary of her work at the ANRI and the ANT experience in this area. [2][3][4] She presented data on 423 UD-HSCT performed between 1996 and 2003 for whom four digit molecular tissue typing for 12 alleles and clinical follow-up data were available. The percentage of wellmatched (10/10) donor-recipient pairs (67%) in the ANT study was greater than that in any other study (44% in the Japanese Marrow Donor Programme study 5 and 47% in the Fred Hutchinson Cancer Research Center study 6 ), in part due to the time period over which the study was performed.…”