Are HLA antigens a risk factor for acute GVHD in thalassemic patients receiving HLA-identical stem cell transplantation?

• Published in: Transplantation proceedings 2004-12, Vol.36 (10), p.3190-3193
• Main Authors: Mohyeddin Bonab, M., Alimoghaddam, K., Vatandoust, S., Forouzia, F., Jahani, M., Ghavamzadeh, A.
• Format: Article
• Language: English
• Subjects: ABO Blood-Group System; Adolescent; Adult; Anemias. Hemoglobinopathies; Biological and medical sciences; Blood Group Incompatibility; Child; Child, Preschool; Diseases of red blood cells; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft vs Host Disease - epidemiology; Hematologic and hematopoietic diseases; Histocompatibility Testing; HLA Antigens - immunology; Humans; Living Donors; Male; Medical sciences; Nuclear Family; Platelet Transfusion; Retrospective Studies; Risk Factors; Stem Cell Transplantation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thalassemia - immunology; Thalassemia - therapy; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.10.088

We retrospectively evaluated the association between risk factors and acute graft-versus-host disease (aGVHD) among 182 beta thalassemia patients who received 73 peripheral blood stem cell (PBSC) or 109 bone marrow transplants from HLA-identical siblings between 1991 and 2003. The relationship between the severity of aGVHD was examined for the following factors: HLA antigens, age, sex, ABO mismatch, sex mismatch (between recipient and donor), thalassemia class, graft source, transplant cell dose, CD3 + cell dose, conditioning regimen, GVHD prophylaxis, neutrophil engraftment duration, and blood product transfusions using univariate and multivariate analyses. Overall 61 (34%) patients developed clinical grade III or grade IV aGVHD. Univariate analysis confirmed an increased risk of severe aGVHD, which was associated with HLA-A11, HLA-A26, and PBSCT ( P = .04, .03, and .03, respectively). The risk of aGVHD was reduced in the presence of HLA-A3 ( P = .03). Multivariate analysis confirmed the increased risk of aGVHD associated with HLA-A11 ( P = .04), HLA-A26 ( P = .01), and a short-period neutrophil recovery ( P = .009). In this study HLA-A11, HLA-A26, PBSCT, and a short neutrophil engraftment period were probable risk factors and HLA-A3 a probable protective factor associated with severe aGVHD. These data may provide useful guidelines to choose strategies for treatment and prevention.