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Hla-DPB1 mismatch in HLA-A-B-DRB1 identical sibling donor stem cell transplantation and acute graft-versus-host disease. 2004
David Gallardo, and
Salut Brunet, and
Antonio Torres, and
Manuela Alonso-Nieto, and
Carlos Vallejo, and
Antonio Jiménez, and
Marcos González, and
Guillermo Sanz, and
David Serrano, and
Ildefonso Espigado, and
Santiago Osorio, and
Enric Carreras, and
Carmen Martiín, and
César Sanz-Rodríguez, and
Jorge Sierra, and
Javier Zuazu, and
M Francisca González-Escribano, and
Juan R González, and
José Román, and
Jaime Pérez De Oteyza, and
Rafael De La Cámara
Alloreactivity Unit of the Institut Català d'Oncologia, Barcelona, Spain. 27532dgg@comb.es
BACKGROUND The role of human leukocyte antigen (HLA)-DPB1 as a transplantation antigen is controversial. A higher incidence of acute graft-versus-host disease (aGVHD) has been described after unrelated donor bone marrow transplant when both HLA-DPB1 alleles were mismatched. METHODS We investigated the impact of a single HLA-DPB1 mismatch after HLA-A-B-DRB1 identical sibling donor transplantation on aGVHD. We analyzed 627 adult patient-donor pairs and identified 30 pairs without HLA-DPB1 identity (4.78%). In 17 cases, the patient had an allele that was not shared by the donor. RESULTS The cumulative incidence of grades II-IV aGVHD was higher in the HLA-DPB1 mismatched group (66.7% vs. 35.7%, p=0.012). The HLA-DPB1 mismatch was identified by multivariate analysis as an independent risk factor for aGVHD (p=0.020, RR=2.68, 95% CI: 1.73-3.62). CONCLUSIONS HLA-DPB1 can mediate alloreactive responses. A single HLA-DPB1 mismatch increases the risk of aGVHD after sibling donor stem cell transplantation.
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