TY - JOUR
T1 - HLA-DRB3/4/5 mismatches are associated with increased risk of acute GVHD in 10/10 matched unrelated donor hematopoietic cell transplantation
AU - on behalf of the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC) and the Société Francophone d'Histocompatibilité et d'Immunogénétique (SFHI)
AU - Ducreux, Stéphanie
AU - Dubois, Valérie
AU - Amokrane, Kahina
AU - Yakoub-Agha, Ibrahim
AU - Labalette, Myriam
AU - Michallet, Mauricette
AU - Rubio, Marie Thérèse
AU - Kennel, Anne
AU - Forcade, Edouard
AU - Lafarge, Xavier
AU - Bulabois, Claude Eric
AU - Masson, Dominique
AU - Daguindau, Etienne
AU - Devys, Anne
AU - Moalic, Virginie
AU - Quelvennec, Erwann
AU - Boudifa, Abdelali
AU - Picard, Christophe
AU - Van Endert, Peter
AU - de Matteis, Muriel
AU - Delbos, Florent
AU - Filloux, Matthieu
AU - Pedron, Béatrice
AU - Renac, Virginie
AU - Hau, Françoise
AU - Bonneau, Julie
AU - Parissiadis, Anne
AU - Fort, Marylise
AU - Dormoy, Anne
AU - Maillard, Natacha
AU - Jollet, Isabelle
AU - Chevallier, Patrice
AU - Cesbron, Anne
AU - Bay, Jacques Olivier
AU - Quainon, Fabienne
AU - Garnier, Federico
AU - Socié, Gérard
AU - Loiseau, Pascale
AU - Porcher, Raphaël
AU - Peffault de Latour, Régis
N1 - Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Matching for HLA-A, -B, -C, and -DRB1 loci (8/8 match) is currently the gold standard for unrelated donor hematopoietic cell transplantation (HCT). In Europe, patients are also matched at the HLA-DQB1 loci (10/10 match). However, there is increasing evidence that matching at HLA-DRB3/4/5 loci may help to lower transplant-related morbidity and mortality. We therefore investigated the impact of HLA-DRB3/4/5 mismatches on outcomes in 1975 patients who received a first 10/10 matched unrelated donor (MUD) HCT in France from 2000 to 2012 for a hematological malignancy. High-resolution typing was performed at HLA-A, -B, -C, -DRB1, -DQB1, -DPB1, and -DRB3/4/5 loci for all donor/recipient pairs. Compared with DRB3/4/5-matched pairs, patients who received a MUD HCT from a DRB3/4/5 mismatched donor had a significantly increased risk of grade II-IV acute graft-versus-host disease (aGVHD) (Adjusted Hazard Ratio (HR) 1.43 (1.07 to 1.90)) associated with lower graft-versus-host disease-free and relapse-free survival (GRFS) (Adjusted HR 1.20 (1.02 to 1.42)). Conversely, we observed no differences in terms of chronic GVHD, nonrelapse mortality, relapse and overall survival. However, we believe that patients stand to benefit from DRB3/4/5 loci being considered for unrelated donor selection to improve GRFS and then quality of life after unrelated HCT.
AB - Matching for HLA-A, -B, -C, and -DRB1 loci (8/8 match) is currently the gold standard for unrelated donor hematopoietic cell transplantation (HCT). In Europe, patients are also matched at the HLA-DQB1 loci (10/10 match). However, there is increasing evidence that matching at HLA-DRB3/4/5 loci may help to lower transplant-related morbidity and mortality. We therefore investigated the impact of HLA-DRB3/4/5 mismatches on outcomes in 1975 patients who received a first 10/10 matched unrelated donor (MUD) HCT in France from 2000 to 2012 for a hematological malignancy. High-resolution typing was performed at HLA-A, -B, -C, -DRB1, -DQB1, -DPB1, and -DRB3/4/5 loci for all donor/recipient pairs. Compared with DRB3/4/5-matched pairs, patients who received a MUD HCT from a DRB3/4/5 mismatched donor had a significantly increased risk of grade II-IV acute graft-versus-host disease (aGVHD) (Adjusted Hazard Ratio (HR) 1.43 (1.07 to 1.90)) associated with lower graft-versus-host disease-free and relapse-free survival (GRFS) (Adjusted HR 1.20 (1.02 to 1.42)). Conversely, we observed no differences in terms of chronic GVHD, nonrelapse mortality, relapse and overall survival. However, we believe that patients stand to benefit from DRB3/4/5 loci being considered for unrelated donor selection to improve GRFS and then quality of life after unrelated HCT.
UR - http://www.scopus.com/inward/record.url?scp=85051696994&partnerID=8YFLogxK
U2 - 10.1002/ajh.25133
DO - 10.1002/ajh.25133
M3 - Article
AN - SCOPUS:85051696994
SN - 0361-8609
VL - 93
SP - 994
EP - 1001
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 8
ER -