High-Resolution Typing of HLA-DRB1 Is Necessary to Prevent GvHD

Background and Aim: Allogeneic hematopoietic cell transplantation(aHCT) is a curative solution for patients with malignant and other blooddiseases. Human leukocyte antigen (HLA) and specifically HLA-DRB1is one the most important antigens that should be taken into account inaHCT. Although the donor-recipient matching of HLA-DRB1 is consideredin aHCT, the probability of life-threatening aHCT consequences suchas graft-versus-host disease (GvHD) is inevitable which might be dueto the low-resolution typing and matching of HLA between donor andrecipient. In this study, we investigated the GvHD rate in the HLA-DRB1donor-matched patients.Methods: Retrospective clinical records (HLA-DRB1 type, GvHD status,and mortality rate) were collected from 190 patients who underwentaHCT with fully donor-recipient HLA-A, -B, -C, and DR-B1 matchedduring 2008-2017 at hematopoietic stem cell transplantation centerof Taleghani hospital, Tehran, Iran. The HLA typing method was lowresolutionpolymerase chain reaction with single specific primer (PCRSSP)and GvHD status was evaluated according to clinical manifestationand national institute of Health (NIH) criteria. The association of thetypes of HLA-DRB1 in donor-recipient fully matched patients with GvHDand mortality rate were analyzed using multivariate analysis.Results: Despite the HLA matching between donor and recipient,patients with HLA-DRB1*11 have significant higher rate of acute GvHD(aGvHD) (P value= 0.04, RR= 1.31), chronic GvHD (cGvHD) (P value=0.02, RR=1.32), and also significant higher mortality rate (P value=0.007, RR= 1.04).Conclusion: Our results illustrated that in spite of the HLA matching,the patients with HLA-DRB1*11 are more susceptible to both types ofGvHD and have more mortality rate. This suggests that the HLA-DRB1should be typed and matched with high-resolution methods or at leastthese susceptible patients should be managed and supported more thanthe others.

کلیدواژه ها:

Allogeneic hematopoietic cell transplantation ، Graft-versushostdisease ، Human leukocyte antigen ، HLA-DRB1