HLA-DRB3/4/5 mismatches are associated with increased risk of acute GVHD in 10/10 matched unrelated donor hematopoietic cell transplantation.
Fiche publication
Date publication
mai 2018
Journal
American journal of hematology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RUBIO Marie Thérèse , Dr DAGUINDAU Etienne
Tous les auteurs :
Ducreux S, Dubois V, Amokrane K, Yakoub-Agha I, Labalette M, Michallet M, Rubio MT, Kennel A, Forcade E, Lafarge X, Bulabois CE, Masson D, Daguindau E, Devys A, Moalic V, Quelvennec E, Boudifa A, Picard C, Van Endert P, de Matteis M, Delbos F, Filloux M, Pedron B, Renac V, Hau F, Bonneau J, Parissiadis A, Fort M, Dormoy A, Maillard N, Jollet I, Chevallier P, Cesbron A, Bay JO, Quainon F, Garnier F, Socié G, Loiseau P, Porcher R, Peffault de Latour R, ,
Lien Pubmed
Résumé
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, non-relapse 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. This article is protected by copyright. All rights reserved.
Référence
Am. J. Hematol.. 2018 May 4;: