Sex-specific survival difference in association with HLA-DRB1∗04 following allogeneic haematopoietic stem cell transplantation for lymphoid malignancies.

Abstract

The role of HLA system in allogeneic haematopoietic stem cell transplantation (allo-HSCT) outcome is unarguable. In this study we investigated association of HLA-A,-B and-DRB1 alleles with overall survival (OS) in 186 patients undergoing allo-HSCT for lymphoid malignancies. Analyses confirmed significantly better OS for HLA-DRB1∗04 carriers compared with non-carriers (p = 0.01). Survival benefit was confined to male patients (in multivariate analyses p = 0.034, hazard ratio 0.35, 95% confidence interval 0.13-0.92), whereas in females no difference was noted (p = 0.82). Furthermore, donor gender also affected outcome and transplantation from female HLA-DRB1∗04 carrier donors resulted in superior survival compared with female non-carrier donors (p = 0.01). Combined analyses including recipient/donor gender and HLA-DRB1∗04 showed that survival of male patients varied significantly according to donor gender and HLA-DRB1∗04 carriership (p = 0.04) with best survival among HLA-DRB1∗04 carriers transplanted from female donors. Of relevance to our results, HLA-DRB1∗04 has been documented as risk allele group for lymphoid malignancies, and studies described a male-specific risk. We believe that our findings provide further supporting evidence for sex-specific alterations secondary to HLA-DRB1∗04 or related genes. Further studies are warranted to evaluate whether in contrast to general favour of male donors HLA-DRB1∗04 carrier patients with lymphoid malignancies could benefit from transplantation from female donors.

• Authors: Katalin Balassa, Hajnalka Andrikovics, Peter Remenyi, Arpad Batai, Aniko Szilvasi, Andras Bors, Katalin Piroska Kiss, Katalin Rajczy, Dora Inotai, Eva Torbagyi, Lilla Lengyel, Aniko Barta, Laszlo Gopcsa, Attila Tordai, Tamas Masszi
• Journal: Human immunology (Hum Immunol) Vol. 79 Issue 1 Pg. 13-19 (Jan 2018) ISSN: 1879-1166 [Electronic] United States
• PMID: 29080718 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

Chemical References

• HLA-A Antigens
• HLA-B Antigens
• HLA-DRB1 Chains

Topics

• Adult
• Cohort Studies
• Gene Frequency
• Genetic Predisposition to Disease
• Genotype
• HLA-A Antigens (genetics)
• HLA-B Antigens (genetics)
• HLA-DRB1 Chains (genetics)
• Hematopoietic Stem Cell Transplantation
• Histocompatibility Testing
• Humans
• Hungary
• Leukemia, Lymphoid (genetics, mortality, therapy)
• Lymphoma, Non-Hodgkin (genetics, mortality, therapy)
• Polymorphism, Genetic
• Prognosis
• Retrospective Studies
• Sex Factors
• Transplantation, Homologous
• Treatment Outcome