Background.Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is being widely applied as a therapy for hematological malignancies. The long-term outcome of allo-HSCT depends directly on the ability of cytotoxic T-lymphocytes to recognize and eliminate the residual tumor. CTLA-4 is one of the regulatory proteins that provide control over the development of the immune response. Polymorphisms in the CTLA4 gene can affect its function and the efficiency of the antitumor response.The objective:to study the effect of non-synonymous single nucleotide polymorphism (nsSNP) c.49A>G in the donor CTLA4 gene on tumor control in the recipient of allogeneic hematopoietic stem cells (HSC).Materials and methods.Donors of HSC were genotyped for nsSNP c.49A>G in the CTLA4 gene by the real-time polymerase chain reaction using the allele-specific primers. Genotyping data was validated by Sanger’s sequencing of 22 randomly selected samples. The overall survival, the event-free survival and relapse probability were calculated using the Kaplan–Mayer method. A log-rank test was used to assess the statistical significance of group disparities. A p-value of 0.05 was considered as significant.Results.The frequencies of the CTLA4 gene c.49A>G polymorphism alleles in the observed population (102 healthy donors of HSC) correspond to the frequencies obtained by the “1000 genomes” project for the European population. The effect of the donor CTLA4 polymorphism on the tumor control was evaluated on the cohort of patients with acute leukemia after human leukocyte antigen (HLA) matched HSCT from an unrelated donor. It was shown, the three-year relapse-free survival was significantly lower for those patients who received grafts from a donor with the homozygous A/A state of nsSNP c.49A>G (p = 0.01), it was 12.7 % versus 62,8 % in group with c.49A>G G/G and A/G donor genotypes. The incidence of relapse was also significantly different for the group with A/A genotype and for the group with G/G or A/G genotypes of the nsSNP and equaled to 83.7 and 29.3 % respectively (p = 0.03).Conclusion.Patients with acute leukemia, who underwent allo-HSCT from unrelated completely HLA-matched donors with c.49A>G G/G or A/G genotypes have the significantly lower risk of relapse than patients whose donors had the A/A genotype. These results suggest practicability of the nsSNP genotyping for the optimal donor selection.
Hematopoietic stem cell transplantation (HSCT) from healthy donors is used for blood cancer treatment. Alloreactive graft-versus-host disease (GvHD) is one of the post-transplant detrimental side effects, and the main reason for GVHD after HSCT fully matched for human leukocyte peptide antigens (HLA) presented by HLA molecules on cell surface. These polymorphic peptides, minor histocompatibility antigens (MiHA), arise from any genes, including those expressed at hematopoietic tissues. The latter may lead to the s.c. graft-versus-leukemia effect (GvL), thus preventing relapse of a malignancy. A*02:01 is one of the most frequent HLA alleles for European part of Russia. We assessed frequencies for 20 MiHA-encoded genetic polymorphisms, presented via A*02:01 allele, for plausible bone marrow donors, or hematopoietic stem cells (HSC) from the Donor Registry at Russian National Research Center for Hematology, we have also determined a number of immunogenic mismatches for these 20 MiHA in real donor – recipient pairs. A total of 608 potential donors, 90 donors and 92 recipients were genotyped. Using public data, we have shown that frequencies for MiHA coding genes are most close to appropriate frequencies among the European population. We have calculated probability of MiHA-specific alloimmune response after HSCT: there are chances of 33 and 75% for three or more immunogenic mismatches (IM) for related and unrelated HSCTs, respectively. Real frequencies for immune mismatch in 20 related and 20 unrelated donor – recipient pairs are in accordance with estimated theoretical probabilities. As based on the calculated frequencies, we suggest the LB-NDC80- 1P/A, LB-CCL4- 1T, and HA-1 MiHA to be the most promising minor antigens for targeted cell therapies of hematopoietic tissue malignancies. The data obtained could be used for planning allo-HSCTs in Russian patients.
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