학술논문

HLA-DP mismatch and CMV reactivation increase risk of aGVHD independently in recipients of allogeneic stem cell transplant.
Document Type
article
Source
Pathologie et Biologie. 67(2)
Subject
Allogeneic hematopoietic stem cell transplantation
CMV
HLA-DP
Acute Disease
Adult
Aged
Cytomegalovirus
Cytomegalovirus Infections
Female
Graft vs Host Disease
HLA-DP Antigens
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Leukemia
Myeloid
Acute
Male
Middle Aged
Myelodysplastic Syndromes
Retrospective Studies
Risk Factors
Transplant Recipients
Transplantation Immunology
Transplantation
Homologous
Virus Activation
Young Adult
Language
Abstract
HLA-DP mismatched allogeneic hematopoietic stem cell transplantation (allo-HCT) is associated with increased risk of aGVHD and decreased risk of relapse with no effects on overall survival (OS). It has been proposed that CMV-reactivation induces expression of HLA-DP molecules on GVHD target tissues by releasing inflammatory cytokines. We hypothesized that the increased GVHD incidence in HLA-DP mismatched allo-SCTs correlates with recipient CMV serostatus or CMV reactivation. In addition, CMV reactivation is associated with increased risk of GVHD with an unknown mechanism. Here, we analyzed the association between HLA-DPB1 and CMV reactivation on cumulative incidence of aGVHD and relapse as well as OS in 613 patients with AML and MDS who underwent matched related or unrelated allo-HCT at MD Anderson Cancer Center from 2005 to 2011. In multivariable analysis, HLA-DPB1 mismatching was associated with increased risk of aGVHD (hazard ratio (HR): 1.53, P