HLA-DRB3/4/5 mismatches are associated with increased risk of acute GVHD in 10/10 matched unrelated donor hematopoietic cell transplantation - Université Paris Cité Accéder directement au contenu
Article Dans Une Revue American Journal of Hematology Année : 2018

HLA-DRB3/4/5 mismatches are associated with increased risk of acute GVHD in 10/10 matched unrelated donor hematopoietic cell transplantation

1 EFS - Etablissement français du sang - Auvergne-Rhône-Alpes
2 Hôpital Saint-Louis
3 CHRU Lille - Service de neurophysiologie clinique
4 LIRIC - Lille Inflammation Research International Center - U 995
5 EA 2686 - Laboratoire d'Immunologie
6 Service d'hématologie [Hôpital Edouard Herriot - HCL]
7 Service d'Hématologie [CHRU Nancy]
8 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
9 CIRID - Composantes innées de la réponse immunitaire et différenciation
10 Département de cancérologie et d'hématologie
11 Service d'hématologie
12 Etablissement français du sang [Angers]
13 Laboratoire de Génétique Moléculaire et d'Histocompatibilité [Brest]
14 EFS - Etablissement français du sang - Normandie
15 CHU Pitié-Salpêtrière [AP-HP]
16 ADES - Anthropologie bio-culturelle, Droit, Ethique et Santé
17 Diabète de Type 1 : mécanismes et traitements immunologiques
18 Laboratoire d'histocompatibilité et d'immunogénétique [Angers]
19 Développement du Systeme Immunitaire
20 CRIBL - Contrôle de la Réponse Immune B et des Lymphoproliférations
21 AP-HP Hôpital universitaire Robert-Debré [Paris]
22 Laboratoire de Biologie Médicale [Rennes]
23 EFS - alsace strasbourg - Etablissement Français du Sang - Grand Est
24 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
25 EFS BFC - Etablissement français du sang [Bourgogne-Franche-Comté]
26 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
27 EFS - Etablissement français du sang [Poitiers]
28 CHU Nantes - Centre Hospitalier Universitaire de Nantes
29 Etablissement Français du Sang [Nantes]
30 CHU Clermont-Ferrand
31 EFS - Etablissement français du sang [Clermont-Ferrand]
32 Agence de la biomédecine [Saint-Denis la Plaine]
33 AP-HP - Hopital Saint-Louis [AP-HP]
34 Immunogénétique humaine
35 Département d'épidémiologie, biostatistique et recherche clinique
36 IUH - Institut Universitaire d'Hématologie

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, 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.

Dates et versions

hal-01804098 , version 1 (31-05-2018)

Identifiants

Citer

Stéphanie Ducreux, Valérie Dubois, Kahina Amokrane, Ibrahim Yakoub-Agha, Myriam Labalette, et al.. HLA-DRB3/4/5 mismatches are associated with increased risk of acute GVHD in 10/10 matched unrelated donor hematopoietic cell transplantation. American Journal of Hematology, 2018, 93 (8), p.994-1001. ⟨10.1002/ajh.25133⟩. ⟨hal-01804098⟩
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