Association between human leukocyte antigens and graft-versus-host disease occurrence after allogenic hematopoietic stem cell transplantation

Abstract

CONTEXT AND OBJECTIVE: Graft-versus-host disease (GVHD) is one of the complications following allogenic stem cell transplantation. This study investigated an association between human leukocyte antigen (HLA) and the occurrence of acute and chronic GVHD in patients who had received stem cell transplantations from HLA-identical siblings. DESIGN AND SETTING: Retrospective study at Hematology and Hemotherapy Center, Universidade Estadual de Campinas (Unicamp). METHODS:The participants were 176 patients whose first transplant was between 1997 and 2009. HLA genotyping was performed serologically and using the polymerase chain reaction with specific primer sequence. RESULTS: Acute GVHD was positively associated with HLA-A10 (P = 0.0007), HLA-A26 (P = 0.002), B55 (P = 0.001), DRB1*15 (P = 0.0211) and DQB1*05 (P = 0.038), while HLA-B16 (P = 0.0333) was more frequent in patients without acute GVHD. Chronic GVHD was positively associated with HLA-A9 (P = 0.01) and A23 (P = 0.0292) and negatively with HLA-A2 (P = 0.0031) and B53 (P = 0.0116). HLA-B35 (P = 0.0373), B49 (P = 0.0155) and B55 (P = 0.0024) were higher in patients with acute GVHD grade 3 or above, than in other patients. In patients with extensive chronic GVHD, HLA-A9 (P = 0.0004), A24 (P = 0.0059) and A26 (P = 0.0411) were higher than in other patients, while HLA-A2 was lower (P = 0.0097).CONCLUSION: This study suggests that HLA can influence the incidence and severity of acute and chronic GVHD. However, a study with a better design and more patients will be needed to confirm these results. RESULTADOS: A DECH aguda foi associada positivamente com HLA-A10 (P = 0,0007), HLA-A26 (P = 0,002), B55 (P = 0,001), DRB1*15 (P = 0,0211) e DQB1*05 (P = 0,038), enquanto HLA-B16 (P = 0,0333) foi mais frequente em pacientes sem DECH aguda. A DECH crônica foi associada positivamente com HLA-A9 (P = 0,01) e A23 (P = 0,0292) e, negativamente, com HLA-A2 (P = 0,0031) e B53 (P = 0,0116). HLA-B35 (P = 0,0373), B49 (P = 0,0155) e B55 (P = 0,0024) estavam aumentados em pacientes com DECH aguda grau 3 ou maior, em comparação aos outros pacientes. Em pacientes com DECH crônica extensa, HLA-A9 (P = 0,0004), A24 (P = 0,0059) e A26 (P = 0,0411) estavam aumentados em comparação aos outros pacientes, enquanto HLA-A2 estava diminuído (P = 0,0097). CONCLUSÕES: Este estudo sugere que o HLA pode influenciar a ocorrência de DECH aguda e crônica e a sua gravidade. No entanto, um estudo com melhor desenho e com mais pacientes será necessário para confirmar esses resultados. RESUMO

Assessment of risk factors for acute graft-versus-host disease post-hematopoietic stem cell transplantation: a retrospective study based on a proportional odds model using a nonlinear mixed-effects model

“…HLA antigens from host tissues are recognized by donor T cells which are critical for the development of GVHD. 33 The incidence of aGVHD is related to the degree of HLA mismatch. It was reported that the incidence of aGVHD was 35–45% and 60–80% for HLA full match and HLA mismatch, respectively.…”

Association Between Human Leukocyte Antigens and Graft-Versus-Host Disease Occurrence in Allogeneic Hematopoietic Stem Cell Transplantation – A 10-Year Experience on Iranian Patients

“…8 In a Brazilian population, increased incidence of acute GVHD grade III or higher was positively correlated with HLA-B*35, B*49, B*55 and in patients with extensive chronic GVHD, HLA-A*9, A*24 and A*26 were higher than other patients, while HLA-A*2 was lower. 9 Racial difference is one of the main factors that lead to the discrepancy between various HLA alleles linked to the risk of GVHD in different studies. In the context of HLA-matched transplantation, the role of specific HLA alleles in decreasing or increasing the incidence of GVHD could be explained by different mechanisms.…”

“…More frequent HLA alleles which either increase or decrease the incidence of GVHD in HLA-identical sibling transplantations were reported in various populations. 8,9 However, some studies did not find any change in the risk of GVHD through HLA antigens after bone marrow transplantation from HLA-identical sibling. 10 In the current study, we investigated any possible association of HLA subclasses and acute/chronic GVHD occurrence as well as OS in patients receiving HLA-matched sibling allo-HSCT.…”

Research contributions for the Nursing care in pediatric transplantation of hematopoietic stem cells / Contribuições da pesquisa para os cuidados de Enfermagem em transplante pediátrico de células-tronco hematopoiéticas

“…10 Recalling that HLA incompatibilities are related to delayed immune reconstitution and increased risk of GVHD and rejection of grafted cells. 11 Hence, by receiving a more aggressive pre-HSCT preparation to prevent rejection, the adverse effects of treatment may be potentiated, compromising the recovery after the HSCT.…”