Therapeutic and diagnostic applications of minor histocompatibility antigen HA-1 and HA-2 disparities in allogeneic hematopoietic stem cell transplantation: a survey of different populations

Biol Blood Marrow Transplant. 2006 Jan;12(1):95-101. doi: 10.1016/j.bbmt.2005.09.017.

Abstract

Minor histocompatibility antigens (mHags) HA-1 and HA-2 are encoded by biallelic loci, with immunogenic variants, HA-1H and HA-2V, which induce strong HLA-A2-restricted alloreactive T-cell responses, and nonimmunogenic counterparts, HA-1R and HA-2M, which represent functional null alleles that are poorly presented by HLA class I molecules. HA-1 and HA-2 are potential targets of selective graft-versus-leukemia and graft-versus-tumor reactivity after allogeneic hematopoietic stem cell transplantation (HSCT); however, these applications are restricted to a limited number of patients. Here, we show that a far more frequent application of HA-1 and HA-2 disparity relies on their use as markers for the state of host chimerism after allogeneic HSCT. We have determined allelic frequencies of 29.3% and 70.7% for HA-1H and HA-1R, respectively, and of 83.7% and 16.3% for HA-2V and HA-2M, respectively, in >200 healthy individuals from northern Italy. Similar frequencies were observed in nearly 100 patients affected by hematologic malignancies or solid tumors, thus showing that HA-1 and HA-2 variability are not associated with the presence of cancer. On the basis of these data, we predict that HA-1 and HA-2 can be used in 32.8% and 23.5% of Italian transplant patients, respectively, as markers for the state of host chimerism, whereas exploitation of disparity for these mHags for targeted immunotherapy will be possible in 10.7% and 1.1% of Italian patients, respectively. Retrospective HA-2 typing of bone marrow aspirates obtained from a patient during complete remission or recurrence of acute myeloid leukemia after haploidentical HSCT showed the feasibility of using HA-2 as a surrogate marker for disease monitoring. Because of an apparent north-south gradient for HA-1 allelic frequencies, with higher frequencies for the HA-1H variant reported in white populations from Southern Europe as compared with Northern Europe and North America, the diagnostic applicability of HA-1 disparity will be slightly more frequent in transplant patients from the north. Taken together, our data show that determination of HA-1 and HA-2 variability can be an important parameter for the selection of allogeneic stem cell donors, in particular for patients affected by hematologic malignancies without a tumor-specific molecular marker.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / analysis
  • Gene Frequency
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / methods*
  • Histocompatibility Testing / methods*
  • Humans
  • Italy / epidemiology
  • Leukemia, Myeloid / diagnosis
  • Leukemia, Myeloid / immunology
  • Minor Histocompatibility Antigens / analysis*
  • Minor Histocompatibility Antigens / genetics
  • Molecular Epidemiology
  • Neoplasm Proteins / analysis*
  • Neoplasm Proteins / genetics
  • Oligopeptides / analysis*
  • Oligopeptides / genetics
  • Tissue Donors*
  • Transplantation Chimera*
  • Transplantation, Homologous

Substances

  • Biomarkers
  • HA-1 antigen
  • HA-2 antigen
  • Minor Histocompatibility Antigens
  • Neoplasm Proteins
  • Oligopeptides