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Morishima S, Yoshimitsu M, Shindo T, Utsunomiya A, Ishida T, Ito A, Nakano N, Kawakita T, Eto T, Suehiro Y, Itonaga H, Mori Y, Miyazaki Y, Kanda J, Uchida N, Sawayama Y, Tomori S, Ichinohe T, Atsuta Y, Fukuda T, Kato K. Individual HLAs affect survival after allogeneic stem cell transplantation in adult T-cell leukaemia/lymphoma. HLA 2024; 103:e15555. [PMID: 38887872 DOI: 10.1111/tan.15555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/02/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024]
Abstract
Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is the only curative therapy for adult T-cell leukaemia/lymphoma (ATL). Specific HLAs are associated with outcomes of immunotherapy and allo-HSCT. We hypothesised that individual HLAs would affect the clinical outcomes of ATL patients after allo-HSCT. Using data from a Japanese registry, we retrospectively analysed 829 patients with ATL who received transplants from HLA-identical sibling donors or HLA-A, -B, -C or -DRB1 allele-matched unrelated donors between 1996 and 2015. We evaluated the overall mortality risk of HLA-A, -B and -DR antigens with frequencies exceeding 3%. Outcomes were compared between transplants with or without specific HLA antigens. Of the 25 HLAs, two candidates were identified but showed no statistically significant differences by multiple comparison. HLA-B62 was associated with a lower risk of mortality (hazard ratio [HR], 0.68; 95% confidence interval [CI]: 0.51-0.90; p = 0.008), whereas HLA-B60 was associated with a higher risk of mortality (HR, 1.64; 95% CI: 1.19-2.27; p = 0.003). In addition, HLA-B62 was associated with a lower risk of transplant-related mortality (TRM) (HR, 0.52; 95% CI: 0.32-0.85, p = 0.009), whereas HLA-B60 was associated with a higher risk of grades III-IV acute graft-versus-host disease (HR, 2.63; 95% CI: 1.62-4.27; p < 0.001). Neither HLA influenced relapse. The higher risk of acute GVHD in HLA-B60-positive patients and the lower risk of TRM in HLA-B62-positive patients were consistent with previously obtained results from patients with other haematological malignancies. Consideration of HLA in ATL patients may help to predict risk and outcomes after allo-HSCT.
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Affiliation(s)
- Satoko Morishima
- Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Makoto Yoshimitsu
- Department of Hematology and Rheumatology, Kagoshima University Hospital, Kagoshima, Japan
| | - Takero Shindo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atae Utsunomiya
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Takashi Ishida
- Department of Immunology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayumu Ito
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Youko Suehiro
- Department of Hematology and Cell Therapy, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hidehiro Itonaga
- Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | - Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Yasushi Sawayama
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - Shouhei Tomori
- Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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Grubic Z, Maskalan M, Burek Kamenaric M, Desnica L, Mikulic M, Stingl Jankovic K, Durakovic N, Serventi Seiwerth R, Vrhovac R, Zunec R. Alternative donor strategy in unrelated hematopoietic stem cell transplantation - outcome with mismatched donors. Adv Med Sci 2023; 68:332-340. [PMID: 37741003 DOI: 10.1016/j.advms.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/06/2023] [Accepted: 09/06/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE This study retrospectively investigated the association between the level of human leukocyte antigen (HLA) mismatches (MMs), direction of disparities and differences at particular HLA locus on clinical outcomes of hematopoietic stem cell transplantation (HSCT). Investigated outcomes were overall survival (OS) and disease-free survival (DFS), graft-versus-host disease (GvHD), relapse and non-relapse mortality (NRM). PATIENTS AND METHODS Study cohort included 108 adult patients transplanted between 2011 and 2021 and their 9/10 mismatched unrelated donors (MMUD). All individuals were typed for HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1 loci using Polymerase Chain Reaction-Sequence Specific Primers, PCR-Sequence Based Typing and Next-Generation Sequencing. All statistical analyses were done in the MedCalc software, version 19.2.6. RESULTS Patients with MMs at HLA-B locus demonstrated worse OS (P = 0.0440, HR = 2.00, n = 20). Absence of HLA-DRB5 was associated with a higher incidence of GvHD (P = 0.0112, HR = 1.93, n = 67). A lower incidence of GvHD was observed in patients with HLA class II MMs compared to patients with HLA class I MMs (P = 0.0166, HR = 1.94, n = 29). Finally, analysis of PIRCHE score (PS) impact revealed that patients with HLA class II PS > 10 in GvH direction showed higher incidence of GvHD compared to patients with HLA class II PS < 10 (P = 0.0073, HR = 2.01, n = 55). CONCLUSION Obtained results undisputedly indicate the necessity to further investigate this matter on a larger patient group, with focus on specific HLA alleles to define precisely priority criteria for selecting the best donor for all patients, thus improving the outcome of HSCT with an MMUD.
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Affiliation(s)
- Zorana Grubic
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Marija Maskalan
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Marija Burek Kamenaric
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Lana Desnica
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mirta Mikulic
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Katarina Stingl Jankovic
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Nadira Durakovic
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ranka Serventi Seiwerth
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Radovan Vrhovac
- Department of Hematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Renata Zunec
- Tissue Typing Centre, Clinical Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
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Crocchiolo R, Mele L, Testi M, Scollo Chiara M, Murgia B, Rossi A, Vecchiato C, Grammatico P, Mininni D, Longhi E, Manfroi S, Giuliodori S, Castellani L, Carella G, Lai S, Azzaro Maria P, Mazzi B, Perotti L, Penta R, Lombardo C, Tognellini R, Andreani M, Albergoni Maria P, Nesci S, Cappuzzo V, Chiusolo P, Garino E, Cappucci G, Ceschini N, Bevilacqua E, Guizzardi E, Tagliaferri Cinzia M, Piazza A, Carcassi C, Miotti V. Use of DPB1 T-cell epitope algorithm among italian transplant centers: A survey on behalf of Associazione Italiana di Immunogenetica e Biologia dei Trapianti. HLA 2021; 98:114-121. [PMID: 34155826 DOI: 10.1111/tan.14347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/01/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
The HLA-DPB1 locus has been demonstrated to have a significant role on patients' outcome after allogeneic HSCT, and the so-called T-cell epitope (TCE) algorithm has been incorporated in international guidelines for the selection of unrelated donors. The purpose of the present study is to measure, through a national survey conducted on behalf of the Associazione Italiana di Immunogenetica e Biologia dei Trapianti (AIBT), the extent of awareness and use of HLA-DPB1 TCE-based algorithms during the donor search. 89% of the HLA laboratories answered to a short questionnaire and the results showed a progressive increase of the laboratories typing DPB1 in patients and their potential donors during the search (from 44% to 79% during the 2010-2019 period) as well as the application of a TCE-based algorithm for the donor choice whenever possible (from 24% to 65% during the same period). The DP-permissiveness status is detailed in the official HLA typing report by 12%, 32% and 50% of laboratories in 2010, 2015 and 2019, respectively. The present data indicate an encouraging raise in the awareness of the HLA-DPB1 role in unrelated donor selection; noteworthy, mentioning the TCE-based permissiveness status in the HLA typing report of each potential unrelated donor represents a notable mean to raise awareness among transplant physicians and to support them in their task of choosing the best donor. Nonetheless, despite the compelling evidence of the predictive ability of TCE-based algorithms, further efforts are still needed to extend its application to all transplant centers in Italy.
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Affiliation(s)
- Roberto Crocchiolo
- Servizio di Immunoematologia e Medicina Trasfusionale, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lia Mele
- Laboratorio HLA e processazione cellule staminali ematopoietiche, Azienda Ospedaliera SS Antonio e Biagio e C Arrigo, Alessandria, Italy; Treasurer, Associazione Italiana di Immunogenetica e Biologia dei Trapianti, AIBT, Alessandria, Italy
| | - Manuela Testi
- Secretary, Associazione Italiana di Immunogenetica e Biologia dei Trapianti, AIBT, Bologna, Italy
| | | | - Barbara Murgia
- SC laboratorio di istocompatibilità, EO Ospedali Galliera, Genoa, Italy
| | - Angela Rossi
- UOSD Immunogenetica e Manipolazione cellule staminali emopoietiche, Ospedale ''Guglielmo da Saliceto'', Piacenza, Italy
| | - Cinzia Vecchiato
- Transfusion Service, San Maurizio Regional Hospital, Bolzano, Italy
| | - Paola Grammatico
- UOC Laboratorio di Genetica Medica, Ospedale San Camillo, Rome, Italy
| | - Donata Mininni
- Tissue Typing and Immunology of Transplants Unit, Department of Diagnostic Pathology, University of Bari, Bari, Italy
| | - Elena Longhi
- Laboratory of Transplant Immunology, IRCCS Ca ' Granda Foundation Maggiore Policlinico Hospital Milan, Milan, Italy
| | - Silvia Manfroi
- Immunohaematology and Transfusion Medicine Service, S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | | | - Laura Castellani
- UOC immunoematologia e medicina trasfusionale, Laboratorio immunogenetica - ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Graziella Carella
- Laboratorio di Istocompatibilità, ''Vittorio Mero'' Servizio di Immunoematologia e Medicina Trasfusionale, ASST Spedali Civili, Brescia, Italy
| | - Sara Lai
- SC Genetica Medica Cagliari - ATS Sardegna, Cagliari, Italy
| | - Pia Azzaro Maria
- Laboratorio di istocompatibilità, Centro Donatori di midollo Osseo (CD-CT02) dell'UOC di Ematologia con trapianto di Midollo Ossero - AOU Policlinico San Marco, Catania, Italy
| | - Benedetta Mazzi
- Immunogenetics laboratory, HLA & Chimerism - Dept. of ImmunoHematology & Blood Transfusion, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Laura Perotti
- Servizio di Immunoematologia e Trasfusionale, ASO Santa Croce e Carle, Cuneo, Italy
| | - Roberta Penta
- Laboratorio di istoconpatibilità, UOSD Criopreservazione e BaSCO, PO Pausilipon - AORN Santobono-Pausilipon, Naples, Italy
| | - Claudia Lombardo
- Laboratorio di Tipizzazione HLA, Servizio Di Immunoematologia e Medicina Trasfusionale, Fondazione IRCSS Istituto Tumori, Milan, Italy
| | - Rita Tognellini
- Laboratorio di immunogenetica e biologia dei trapianti, Servizio Immunoematologia e trasfusionale, Azienda Ospedaliera Perugia, Perugia, Italy
| | - Marco Andreani
- Transplantation Immunogenetics Laboratory, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Sonia Nesci
- Settore di Immunogenetica e Biologia dei Trapianti, S.S.D. Diagnostica ad alta complessità - Dipartimento di Diagnostica Clinica, Azienda Ospedali Riuniti Marche Nord-, Pesaro, Italy
| | - Valentina Cappuzzo
- Laboratorio Regionale di Tipizzazione Tessutale ed Immunologia dei Trapianti, U.O.C. Medicina Trasfusionale e dei Trapianti - P.O. Cervello - A.O.R. Villa Sofia-Cervello, Palermo, Italy
| | - Patrizia Chiusolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Elena Garino
- SC Immunogenetica e Biologia dei Trapianti, A.O.U. Città della Salute e della Scienza di Torino, Pavia, Italy
| | - Giuseppe Cappucci
- IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Nadia Ceschini
- Laboratorio di Tipizzazione Tissutale HLA, S.I.T., Ospedale Santa Chiara, Trento, Italy
| | - Elena Bevilacqua
- Laboratorio di Tipizzazione tissutale, Dipartimento di Medicina Trasfusionale, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | | | | | - Antonina Piazza
- Associazione Italiana di Immunogenetica e Biologia dei Trapianti, AIBT, Bologna, Italy
| | - Carlo Carcassi
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Associazione Italiana di Immunogenetica e Biologia dei Trapianti, AIBT, Cagliari, Italy
| | - Valeria Miotti
- Laboratory of Immunogenetics, Santa Maria della Misericordia University Hospital, Associazione Italiana di Immunogenetica e Biologia dei Trapianti, AIBT, Udine, Italy
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