HLA-DPB1 matching in unrelated hematopoietic stem cell transplantation program contributes to a higher incidence of disease relapse

Hum Immunol. 2017 Nov;78(11-12):665-671. doi: 10.1016/j.humimm.2017.08.008. Epub 2017 Sep 5.

Abstract

The impact of patient/donor matching for HLA-A, -B, -C, -DRB1 and -DQB1 genes in hematopoietic stem cell transplantation (HSCT) is well-recognized, but typing for additional genes, such as HLA-DPB1, is still controversial. Based on defined T-cell epitope (TCE) groups, all HLA-DPB1 mismatches can be classified as permissive or non-permissive. In this retrospective study we analysed 82 patient-matched unrelated donor (MUD) pairs who underwent HSCT, and explored the impact of HLA-DPB1 matches, permissive and non-permissive mismatches on transplantation outcomes. Patient-MUD pairs matched for HLA-DPB1 alleles in univariate analysis were associated with a significantly higher incidence of disease relapse compared to pairs who were permissive/non-permissive HLA-DPB1 mismatched according to the TCE3 and TCE4 algorithms (P=0.025 and P=0.026, respectively), although the significance was lost in multivariate analysis. The analysis did not reveal any significant influence of HLA-DPB1 alleles on overall survival (OS), non-relapse mortality (NRM) or graft-versus-host disease (GvHD) incidence. In conclusion, our study presents evidence that HLA-DPB1 matching influenced the relapse rate in patients after HSCT so the HLA-DPB1 alleles should be implemented in the MUD search algorithm as a transplantation determinant.

Keywords: HLA-DPB1; Haematopoietic stem cell transplantation; Non-permissive mismatch; Permissive mismatch; TCE3 algorithm; TCE4 algorithm.

MeSH terms

  • Adolescent
  • Adult
  • Epitopes, T-Lymphocyte / metabolism
  • Female
  • Genotype
  • Graft Survival
  • Graft vs Host Disease / epidemiology
  • Graft vs Host Disease / genetics*
  • Graft vs Host Disease / mortality
  • HLA-DP beta-Chains / genetics*
  • Hematopoietic Stem Cell Transplantation*
  • Histocompatibility
  • Histocompatibility Testing
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Risk
  • Survival Analysis
  • Young Adult

Substances

  • Epitopes, T-Lymphocyte
  • HLA-DP beta-Chains
  • HLA-DPB1 antigen