Association Between Human Leukocyte Antigens and Graft-Versus-Host Disease Occurrence in Allogeneic Hematopoietic Stem Cell Transplantation - A 10-Year Experience on Iranian Patients.

BACKGROUND

Human leukocyte antigen (HLA) molecules mediate critical roles in determining responsiveness or non-responsiveness of the immune system, especially in transplantation. Some studies have shown a possible association between certain HLA alleles and some allogeneic hematopoietic stem cell transplantation (allo-HSCT) outcomes such as acute/chronic graft-versus-host disease (aGVHD/cGVHD) and overall survival (OS). In the current study, we investigated any possible association of HLA subclasses and acute/chronic GVHD occurrence as well as OS in patients receiving HLA-matched sibling allo-HSCT.

METHODS

We retrospectively evaluated the association of various HLA alleles with the incidence of aGVHD, cGVHD, and OS of 162 patients who received allo-HSCT from HLA-matched sibling between 2009-2018 at Taleghani hospital in Tehran.

RESULTS

We found that the incidence of aGVHD grades II-IV was higher among patients who had HLA-B07 (=0.031) and HLA-DRB107 (=0.052). The presence of HLA-A01 was associated with 4.5-fold greater odds of incidence in the extensive-type of cGVHD (=0.009). Furthermore, HLA-A03 (=0.089), HLA-B13(=0.013), HLA-B40 (=0.042), HLA-DRB102 (=0.074), and HLA-DRB104 (=0.039) were associated with a lower rate of OS.

CONCLUSION

This study suggests that certain HLA alleles might influence the incidence and severity of acute or chronic GVHD in the context of HLA-matched sibling allo-HSCT. In addition, some specific HLA alleles help predict OS in allo-HSCT recipients. These results might be helpful in estimating the incidence of aGVHD, cGVHD, and OS as well as designing personalized therapy.