HLA DR15 Antigen Status Does Not Impact Graft-versus-Host Disease or Survival in HLA-Matched Sibling Transplantation for Hematologic Malignancies

Minoo Battiwalla, Kristin Ellis, Peigang Li, Steven Z. Pavletic, Gorgun Akpek, Peiman Hematti, Thomas R. Klumpp, Richard Maziarz, Bipin N. Savani, Mahmoud D. Aljurf, Mitchell S. Cairo, William R. Drobyski, Biju George, Theresa Hahn, Nandita Khera, Mark R. Litzow, Alison W. Loren, Wael Saber, Mukta Arora, Alvaro Urbano-Ispizua & 3 others Corey Cutler, Mary E D Flowers, Stephen R. Spellman

Research output: Contribution to journalArticle

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Abstract

The HLA class II DRB1 antigen DR15 is an important prognostic marker in immune-mediated marrow failure states. DR15 has also been associated with favorable outcomes (reduced acute graft-versus-host disease [aGVHD] and relapse) after allogeneic hematopoietic cell transplant. To elucidate the impact of DR15 on transplantation outcomes, we conducted a retrospective study of 2891 recipients of first allogeneic stem cell transplant from HLA-matched sibling donors for the treatment of acute leukemia, chronic myeloid leukemia, or myelodysplastic syndrome (MDS) between 1990 and 2007. All patients received conventional myeloablative conditioning, T-replete grafts, and cyclosporine plus methotrexate-based GVHD prophylaxis. DNA-based HLA typing allowed categorization of 732 patients (25.3%) as positive and 2159 patients (74.7%) as negative for DRB1*15:01 or *15:02 (DR15). There were no significant differences in baseline characteristics between the HLA DR15 positive and negative groups. In univariate analysis, HLA-DR15 status had no impact on neutrophil engraftment, aGVHD, chronic GVHD (cGVHD), treatment-related mortality, relapse, disease-free survival, or overall survival (OS). In multivariate analysis, DR15 status showed no significant difference in aGVHD, cGVHD, OS, or relapse. In conclusion, DR15 status had no impact on major HLA-matched sibling donor hematopoietic cell transplant outcomes in this large and homogenous cohort of patients with leukemia and MDS.

Original languageEnglish (US)
Pages (from-to)1302-1308
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume18
Issue number8
DOIs
StatePublished - Aug 2012

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Graft vs Host Disease
Hematologic Neoplasms
Siblings
Transplantation
Transplants
Survival
Myelodysplastic Syndromes
Recurrence
Leukemia
Tissue Donors
Histocompatibility Testing
Histocompatibility Antigens Class II
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
HLA Antigens
Methotrexate
Cyclosporine
Disease-Free Survival
Neutrophils
Stem Cells
Multivariate Analysis

Keywords

  • DR15
  • Graft-versus-lymphoma
  • GVHD
  • Hematopoietic stem cell transplantation (HSCT)
  • Survival

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

HLA DR15 Antigen Status Does Not Impact Graft-versus-Host Disease or Survival in HLA-Matched Sibling Transplantation for Hematologic Malignancies. / Battiwalla, Minoo; Ellis, Kristin; Li, Peigang; Pavletic, Steven Z.; Akpek, Gorgun; Hematti, Peiman; Klumpp, Thomas R.; Maziarz, Richard; Savani, Bipin N.; Aljurf, Mahmoud D.; Cairo, Mitchell S.; Drobyski, William R.; George, Biju; Hahn, Theresa; Khera, Nandita; Litzow, Mark R.; Loren, Alison W.; Saber, Wael; Arora, Mukta; Urbano-Ispizua, Alvaro; Cutler, Corey; Flowers, Mary E D; Spellman, Stephen R.

In: Biology of Blood and Marrow Transplantation, Vol. 18, No. 8, 08.2012, p. 1302-1308.

Research output: Contribution to journalArticle

Battiwalla, M, Ellis, K, Li, P, Pavletic, SZ, Akpek, G, Hematti, P, Klumpp, TR, Maziarz, R, Savani, BN, Aljurf, MD, Cairo, MS, Drobyski, WR, George, B, Hahn, T, Khera, N, Litzow, MR, Loren, AW, Saber, W, Arora, M, Urbano-Ispizua, A, Cutler, C, Flowers, MED & Spellman, SR 2012, 'HLA DR15 Antigen Status Does Not Impact Graft-versus-Host Disease or Survival in HLA-Matched Sibling Transplantation for Hematologic Malignancies', Biology of Blood and Marrow Transplantation, vol. 18, no. 8, pp. 1302-1308. https://doi.org/10.1016/j.bbmt.2012.02.011
Battiwalla, Minoo ; Ellis, Kristin ; Li, Peigang ; Pavletic, Steven Z. ; Akpek, Gorgun ; Hematti, Peiman ; Klumpp, Thomas R. ; Maziarz, Richard ; Savani, Bipin N. ; Aljurf, Mahmoud D. ; Cairo, Mitchell S. ; Drobyski, William R. ; George, Biju ; Hahn, Theresa ; Khera, Nandita ; Litzow, Mark R. ; Loren, Alison W. ; Saber, Wael ; Arora, Mukta ; Urbano-Ispizua, Alvaro ; Cutler, Corey ; Flowers, Mary E D ; Spellman, Stephen R. / HLA DR15 Antigen Status Does Not Impact Graft-versus-Host Disease or Survival in HLA-Matched Sibling Transplantation for Hematologic Malignancies. In: Biology of Blood and Marrow Transplantation. 2012 ; Vol. 18, No. 8. pp. 1302-1308.
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AU - Battiwalla, Minoo

AU - Ellis, Kristin

AU - Li, Peigang

AU - Pavletic, Steven Z.

AU - Akpek, Gorgun

AU - Hematti, Peiman

AU - Klumpp, Thomas R.

AU - Maziarz, Richard

AU - Savani, Bipin N.

AU - Aljurf, Mahmoud D.

AU - Cairo, Mitchell S.

AU - Drobyski, William R.

AU - George, Biju

AU - Hahn, Theresa

AU - Khera, Nandita

AU - Litzow, Mark R.

AU - Loren, Alison W.

AU - Saber, Wael

AU - Arora, Mukta

AU - Urbano-Ispizua, Alvaro

AU - Cutler, Corey

AU - Flowers, Mary E D

AU - Spellman, Stephen R.

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N2 - The HLA class II DRB1 antigen DR15 is an important prognostic marker in immune-mediated marrow failure states. DR15 has also been associated with favorable outcomes (reduced acute graft-versus-host disease [aGVHD] and relapse) after allogeneic hematopoietic cell transplant. To elucidate the impact of DR15 on transplantation outcomes, we conducted a retrospective study of 2891 recipients of first allogeneic stem cell transplant from HLA-matched sibling donors for the treatment of acute leukemia, chronic myeloid leukemia, or myelodysplastic syndrome (MDS) between 1990 and 2007. All patients received conventional myeloablative conditioning, T-replete grafts, and cyclosporine plus methotrexate-based GVHD prophylaxis. DNA-based HLA typing allowed categorization of 732 patients (25.3%) as positive and 2159 patients (74.7%) as negative for DRB1*15:01 or *15:02 (DR15). There were no significant differences in baseline characteristics between the HLA DR15 positive and negative groups. In univariate analysis, HLA-DR15 status had no impact on neutrophil engraftment, aGVHD, chronic GVHD (cGVHD), treatment-related mortality, relapse, disease-free survival, or overall survival (OS). In multivariate analysis, DR15 status showed no significant difference in aGVHD, cGVHD, OS, or relapse. In conclusion, DR15 status had no impact on major HLA-matched sibling donor hematopoietic cell transplant outcomes in this large and homogenous cohort of patients with leukemia and MDS.

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