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Muñiz P, Martínez-García M, Bailén R, Chicano M, Oarbeascoa G, Triviño JC, de la Iglesia-San Sebastian I, Fernández de Córdoba S, Anguita J, Kwon M, Díez-Martín JL, Olmos PM, Martínez-Laperche C, Buño I. Identification of predictive models including polymorphisms in cytokines genes and clinical variables associated with post-transplant complications after identical HLA-allogeneic stem cell transplantation. Front Immunol 2024; 15:1396284. [PMID: 39247183 PMCID: PMC11377344 DOI: 10.3389/fimmu.2024.1396284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/08/2024] [Indexed: 09/10/2024] Open
Abstract
Backgrounds Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative therapy for hematological malignancies, it can be associated with relevant post-transplant complications. Several reports have shown that polymorphisms in immune system genes are correlated with the development of post-transplant complications. Within this context, this work focuses on identifying novel polymorphisms in cytokine genes and developing predictive models to anticipate the risk of developing graft-versus-host disease (GVHD), transplantation-related mortality (TRM), relapse and overall survival (OS). Methods Our group developed a 132-cytokine gene panel which was tested in 90 patients who underwent an HLA-identical sibling-donor allo-HSCT. Bayesian logistic regression (BLR) models were used to select the most relevant variables. Based on the cut-off points selected for each model, patients were classified as being at high or low-risk for each of the post-transplant complications (aGVHD II-IV, aGVHD III-IV, cGVHD, mod-sev cGVHD, TRM, relapse and OS). Results A total of 737 polymorphisms were selected from the custom panel genes. Of these, 41 polymorphisms were included in the predictive models in 30 cytokine genes were selected (17 interleukins and 13 chemokines). Of these polymorphisms, 5 (12.2%) were located in coding regions, and 36 (87.8%) in non-coding regions. All models had a statistical significance of p<0.0001. Conclusion Overall, genomic polymorphisms in cytokine genes make it possible to anticipate the development all complications studied following allo-HSCT and, consequently, to optimize the clinical management of patients.
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Affiliation(s)
- Paula Muñiz
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | - María Martínez-García
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
- Department of Signal Theory and Communications, University Carlos III of Madrid, Madrid, Spain
| | - Rebeca Bailén
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | - María Chicano
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | - Gillen Oarbeascoa
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | | | - Ismael de la Iglesia-San Sebastian
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | - Sara Fernández de Córdoba
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | - Javier Anguita
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | - Mi Kwon
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | - José Luis Díez-Martín
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
- Department of Medicine, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Pablo M Olmos
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
- Department of Signal Theory and Communications, University Carlos III of Madrid, Madrid, Spain
| | - Carolina Martínez-Laperche
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
| | - Ismael Buño
- Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
- Signal Theory and Communications Department, School of Engineering, Carlos III University, Leganés, Madrid, Spain
- Genomics Unit, Gregorio Marañón General University Hospital, IiSGM, Madrid, Spain
- Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain
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Asurappulige HSH, Thomas AD, Morse HR. Genotoxicity of cytokines at chemotherapy-induced 'storm' concentrations in a model of the human bone marrow. Mutagenesis 2023; 38:201-215. [PMID: 37326959 PMCID: PMC10448863 DOI: 10.1093/mutage/gead018] [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: 07/25/2022] [Accepted: 06/14/2023] [Indexed: 06/17/2023] Open
Abstract
Donor cell leukaemia (DCL) is a complication of haematopoietic stem cell transplantation where donated cells become malignant within the patient's bone marrow. As DCL predominates as acute myeloid leukaemia, we hypothesized that the cytokine storm following chemotherapy played a role in promoting and supporting leukaemogenesis. Cytokines have also been implicated in genotoxicity; thus, we explored a cell line model of the human bone marrow (BM) to secrete myeloid cytokines following drug treatment and their potential to induce micronuclei. HS-5 human stromal cells were exposed to mitoxantrone (MTX) and chlorambucil (CHL) and, for the first time, were profiled for 80 cytokines using an array. Fifty-four cytokines were detected in untreated cells, of which 24 were upregulated and 10 were downregulated by both drugs. FGF-7 was the lowest cytokine to be detected in both untreated and treated cells. Eleven cytokines not detected at baseline were detected following drug exposure. TNFα, IL6, GM-CSF, G-CSF, and TGFβ1 were selected for micronuclei induction. TK6 cells were exposed to these cytokines in isolation and in paired combinations. Only TNFα and TGFβ1 induced micronuclei at healthy concentrations, but all five cytokines induced micronuclei at storm levels, which was further increased when combined in pairs. Of particular concern was that some combinations induced micronuclei at levels above the mitomycin C positive control; however, most combinations were less than the sum of micronuclei induced following exposure to each cytokine in isolation. These data infer a possible role for cytokines through chemotherapy-induced cytokine storm, in the instigation and support of leukaemogenesis in the BM, and implicate the need to evaluate individuals for variability in cytokine secretion as a potential risk factor for complications such as DCL.
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Affiliation(s)
- Harshini S H Asurappulige
- School of Applied Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Adam D Thomas
- School of Applied Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - H Ruth Morse
- School of Applied Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
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Liu Y, Liu Y, Liu Y, Chen X, Jia Y. Epidemiology, drug resistance analysis and mortality risk factor prediction of gram-negative bacteria infections in patients with allogeneic hematopoietic stem cell transplantation. Heliyon 2023; 9:e15285. [PMID: 37101646 PMCID: PMC10123215 DOI: 10.1016/j.heliyon.2023.e15285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 03/17/2023] [Accepted: 03/31/2023] [Indexed: 04/08/2023] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective treatment for many malignant and refractory diseases. However, infections, as the most common complication after transplantation, often lead to poor long-term prognosis of patients. In this study, we collected electronic medical records of allo-HSCT recipients with gram-negative bacteria (GNB) infections between January 2012 and September 2021, analyzed epidemiological characteristics and antibiotic sensitivity, and determined independent risk factors for carbapenem-resistant GNB (CR-GNB) infections and death by Logistic and Cox regression models. During the 9-year period, 183 of 968 patients developed GNB infections, of which 58 died. The most common pathogen was Klebsiella pneumoniae. CR-GNB, especially carbapenem-resistant Klebsiella pneumonia (CRKP), carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Escherichia coli (CREC) had a high resistance rate to commonly used clinical antibiotics. Independent risk factors for CR-GNB infections were use of carbapenem antibiotics for >3 days one month before transplantation (OR = 3.244, 95% CI 1.428-7.369, P = 0.005), use of special immunosuppressants after transplantation (OR = 1.21, 95% CI 1.008-1.452, P = 0.041), and time of hematopoietic reconstruction >20 days (OR = 2.628, 95% CI 1.369-5.043, P = 0.004). Independent risk factors for mortality were interval between diagnosis and transplantation >180 days (HR = 2.039, 95% CI 1.05 to 3.963, P = 0.035), total bilirubin levels during infection >34.2 μmol/L (HR = 3.39, 95% CI 1.583-7.256, P = 0.002) and septic shock (HR = 5.345, 95% CI 2.655-10.761, P = 0.000). In conclusion, GNB has a high incidence and mortality in allo-HSCT recipients. Early transplantation for eligible patients, attention to liver function protection, timely identification and treatment of septic shock can help to improve the prognosis of patients.
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Wang L, Yang B, Wei L, Chen D, Zhao Y, Chen Z. Acute graft-versus-host disease after liver transplantation in a close contact with COVID-19: A case report. Transpl Immunol 2021; 68:101435. [PMID: 34216759 PMCID: PMC8245304 DOI: 10.1016/j.trim.2021.101435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 11/24/2022]
Abstract
Acute graft-versus-host disease (aGVHD) is a rare complication after liver transplantation that characterized by high mortality. We presented a case of aGVHD after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). The patient suffered from fever, oral ulcer, rashes and diarrhea and had a co-infection with Cytomegalovirus (CMV). Short tandem repeat (STR) analysis for cluster of differentiation (CD3) cells and skin biopsy indicated aGVHD. His regimens included high dose of steroids, ruxolitinib, basiliximab, local liver radiotherapy and antibiotics prophylaxis, with the withdrawal of tacrolimus and MMF. Unfortunately, he developed an acute rejection followed by cytomegalovirus infection and lung infection. Soon afterwards he was sent to “isolation ward” due to high suspicion for clinical coronavirus disease 2019 (COVID-19). Fortunately, He was excluded from COVID-19 after nucleic acid and antibody tests. Though closely contact with other COVID-19 patients for a month, the patient was not affected with COVID-19 through his careful protective measures. Finally, the patient recovered after antiviral and antifungal treatment. To our knowledge, this is the first case report of a patient recovered from aGVHD as a close contact.
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Affiliation(s)
- Lu Wang
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1905 Jiefang Avenue, Wuhan City, Hubei Province, Wuhan 430030, China
| | - Bo Yang
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1905 Jiefang Avenue, Wuhan City, Hubei Province, Wuhan 430030, China.
| | - Lai Wei
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1905 Jiefang Avenue, Wuhan City, Hubei Province, Wuhan 430030, China.
| | - Dong Chen
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1905 Jiefang Avenue, Wuhan City, Hubei Province, Wuhan 430030, China
| | - Yuanyuan Zhao
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1905 Jiefang Avenue, Wuhan City, Hubei Province, Wuhan 430030, China
| | - Zhishui Chen
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1905 Jiefang Avenue, Wuhan City, Hubei Province, Wuhan 430030, China.
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Wetzel L, Wittig S, Gruhn B. Association of recipient and donor interleukin 6 polymorphisms 174 and 597 with outcome after allogeneic hematopoietic stem cell transplantation in children. J Cancer Res Clin Oncol 2021; 148:255-265. [PMID: 34120222 PMCID: PMC8752556 DOI: 10.1007/s00432-021-03677-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/27/2021] [Indexed: 11/12/2022]
Abstract
Purpose The success of allogeneic hematopoietic stem cell transplantation (HSCT) is compromised by complications such as infection, relapse, and graft-versus-host disease (GVHD). The investigation of non-HLA immunogenetics, particularly of cytokines, could identify predictors of an unfavorable outcome after allogeneic HSCT. In this study, we examined the impact of single nucleotide polymorphisms (SNPs) within the promoter region of interleukin 6 (IL6) on the development of GVHD after pediatric allogeneic HSCT. Methods In this retrospective analysis, we included 320 pediatric patients with a median age of 10 years who underwent an allogeneic HSCT and their respective donors. We used TaqMan real-time polymerase chain reaction to analyze the SNPs IL6-174 (G/C) and IL6-597 (G/A). The IL6-174 polymorphism was examined in 300 recipients and 295 donors. The IL6-597 polymorphism was analyzed in 299 recipients and 296 donors. We investigated the influence of the IL6-174 and IL6-597 polymorphisms on overall survival, event-free survival, relapse incidence, transplant-related mortality, and the occurrence of GVHD. Results G polymorphism at position 174 of the recipient IL6 gene was associated with a higher incidence of acute GVHD (GG vs. GC/CC; P = 0.024). Patients with IL6-597 GG genotype developed acute GVHD more frequently than individuals with an A allele (GG vs. GA vs. AA; P = 0.013). IL6-174 GG homozygous recipients had a more frequent occurrence of chronic GVHD (GG vs. GC/CC; P = 0.049). We observed a significant increased risk of chronic GVHD in recipients with IL6-597 GG genotype (GG vs. GA vs. AA; P = 0.043). Polymorphisms of donors did not affect the incidence of acute GVHD and chronic GVHD. In multivariate analysis, the IL6-174 and IL6-597 SNPs were independent significant risk factors for acute GVHD (P = 0.030; P = 0.007, respectively) as well as for chronic GVHD (P = 0.045; P = 0.015, respectively). In addition, older age at time of transplantation turned out to be a significant risk factor for chronic GVHD (P = 0.003). Conclusion Our study identified the IL6-174 and IL6-597 GG genotypes of pediatric allogeneic HSCT recipients as genetic risk factors for the development of acute GVHD and chronic GVHD. After evaluations in further studies, these findings could implicate the adjustment of prophylactic measures to reduce the occurrence of acute GVHD and chronic GVHD.
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Affiliation(s)
- Laura Wetzel
- Department of Pediatrics, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Susan Wittig
- Department of Pediatrics, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Bernd Gruhn
- Department of Pediatrics, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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6
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Individual HLA alleles and risk of graft-versus-host disease after haematopoietic stem cell transplantation from HLA-identical siblings. Biologia (Bratisl) 2020. [DOI: 10.2478/s11756-020-00510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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7
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Chen DP, Chang SW, Wang PN, Hus FP, Tseng CP. Association between single nucleotide polymorphisms within HLA region and disease relapse for patients with hematopoietic stem cell transplantation. Sci Rep 2019; 9:13731. [PMID: 31551439 PMCID: PMC6760494 DOI: 10.1038/s41598-019-50111-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 09/04/2019] [Indexed: 11/23/2022] Open
Abstract
Disease relapse occurs in patients with leukemia even hematopoietic stem cell transplantation (HSCT) was performed with human leukocyte antigen (HLA)-matched donors. As revealed previously by Petersdorf et al., there are nine single nucleotide polymorphisms (SNPs) located in the HLA region that potentially modulate the efficacy of HSCT. In this study, we investigated whether or not the genomic variants 500 base pairs flanking the nine transplantation-related SNPs were related to the risk of post-HSCT relapse for patients with leukemia (n = 141). The genomic DNAs collected from 85 patients with acute myeloid leukemia (AML), 56 patients with acute lymphocytic leukemia (ALL), and their respective HLA-matched donors were subject to SNPs analysis, conferred by the mode of mismatch between donor-recipient pair or by recipient or donor genotype analysis. Seven SNPs were revealed to associate with the risk of relapse post-HSCT. For patients with AML, the increased risk of post-HSCT relapse was associated with the donor SNP of rs111394117 in the intron of NOTCH4 gene, and the recipient SNPs of rs213210 in the ring finger protein 1 (RING1) gene promoter, and rs17220087 and rs17213693 in the intron of HLA-DOB gene. For patients with ALL, the increased risk of post-HSCT relapse was associated with the donor SNP of rs213210 in the RING1 gene promoter, and the recipient SNPs of rs79327197 in the HLA-DOA gene promoter, rs2009658 in the telomeric end of lymphotoxin-alpha (LTA) gene, rs17220087 and rs17213693 in the intron of HLA-DOB gene, and rs2070120 in the 3′-UTR of HLA-DOB gene. This study sheds new insight into selecting better candidate donors for performing HSCT in patients with AML and ALL.
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Affiliation(s)
- Ding-Ping Chen
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Su-Wei Chang
- Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Po-Nan Wang
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Fang-Ping Hus
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Ping Tseng
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan. .,Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan.
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Houdová L, Fetter M, Jindra P, Georgiev D. Optimal Donor Selection During Verification Process: Which Factors Are Worth Knowing? Transplant Proc 2018; 50:3082-3087. [PMID: 30577170 DOI: 10.1016/j.transproceed.2018.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/31/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The selection of optimal donor is crucial for successful hematopoietic stem cell transplantation (HSCT). Thereby, it is appropriate to know, in addition to basic human leukocyte antigen (HLA) gene matches, other immunogenic or nonimmunogenic parameters predicting the outcome of transplant. OBJECTIVE A unified approach is necessary to provide a comprehensive view of the patient-donor compatibility characterization outside of standard HLA genes. The approach should be applicable as a tool for optimizing procedures for extended donor typing and/or verification typing of a donor. METHODS The study used the summary, unification, and innovation of existing practical knowledge and experience of the Czech National Marrow Donor Registry of various factors beyond HLA matching with impact on transplant outcome. RESULTS An information technology system-implemented procedure (a verification algorithm) is presented as the decision support approach for prematurely discarding less suitable donors from the transplantation process. It is intended primarily for the transplant specialist to help establish optimal procedures for verifying and determining donor critical factors. CONCLUSIONS A process defining HLAs, killer cell immunoglobulin-like receptors, and cytokine typing strategies was proposed to provide support to a transplant specialist in refining the choice of a suitable donor.
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Affiliation(s)
- L Houdová
- New Technologies for the Information Society, University of West Bohemia, Plzen, Czech Republic.
| | - M Fetter
- New Technologies for the Information Society, University of West Bohemia, Plzen, Czech Republic
| | - P Jindra
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University in Prague, Plzen, Czech Republic; Charles University Hospital Pilsen, Plzen, Czech Republic
| | - D Georgiev
- New Technologies for the Information Society, University of West Bohemia, Plzen, Czech Republic
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Chen DP, Chang SW, Jaing TH, Wang WT, Hus FP, Tseng CP. Single nucleotide polymorphisms within HLA region are associated with disease relapse for patients with unrelated cord blood transplantation. PeerJ 2018; 6:e5228. [PMID: 30083439 PMCID: PMC6076982 DOI: 10.7717/peerj.5228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 06/21/2018] [Indexed: 12/13/2022] Open
Abstract
Disease relapse occurs in unrelated cord blood transplantation (CBT) even when the alleles of human leukocyte antigen (HLA) are fully matched between donor and recipient. This is similar to that observed in other types of hematopoietic stem cell transplantation. Fourteen single nucleotide polymorphisms (SNPs) within the HLA region have been reported previously by Petersdorf et al. and Piras et al. as transplantation determinants in unrelated hematopoietic cell transplantation. In this study, the genomic sequences within 500 base pairs upstream and downstream of the fourteen transplantation-related SNPs from 53 patients and their HLA-matched unrelated donors were analyzed for determining whether or not genetic variants, conferred by either recipient or donor SNP genotype or by recipient-donor SNP mismatching, were associated with the risk of relapse. Seven SNPs were associated with the risk of relapse in unrelated CBT. These included the donor genotype with the SNPs of rs2523675 and rs2518028 at the telomeric end of HCP5 gene, rs2071479 in the intron of the HLA-DOB gene, and rs2523958 in the MICD gene; and the recipient genotype with SNPs of rs9276982 in the HLA-DOA gene, and rs435766 and rs380924 in the MICD gene. As measured by pair-wise linkage disequilibrium (LD) with D′ as the parameter for normalized standard measurement of LD which compares the observed and expected frequencies of one haplotype comprised by alleles at different loci, rs2523675 had high LD with rs4713466 (D′ = 0.86) and rs2523676 (D′ = 0.91) in the HCP5 gene. The rs2518028 had no LD with all other SNPs except rs2523675 (D′ = 0.76). This study provides the basis for developing a method or algorithm for selecting better unrelated CBT candidate donors.
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Affiliation(s)
- Ding-Ping Chen
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Su-Wei Chang
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tang-Her Jaing
- Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan
| | - Wei-Ting Wang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Fang-Ping Hus
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Ping Tseng
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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10
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Reddy P, Ferrara JL. Graft-Versus-Host Disease and Graft-Versus-Leukemia Responses. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00108-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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11
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Gam R, Shah P, Crossland RE, Norden J, Dickinson AM, Dressel R. Genetic Association of Hematopoietic Stem Cell Transplantation Outcome beyond Histocompatibility Genes. Front Immunol 2017; 8:380. [PMID: 28421078 PMCID: PMC5377073 DOI: 10.3389/fimmu.2017.00380] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 03/16/2017] [Indexed: 12/18/2022] Open
Abstract
The outcome of hematopoietic stem cell transplantation (HSCT) is controlled by genetic factors among which the leukocyte antigen human leukocyte antigen (HLA) matching is most important. In addition, minor histocompatibility antigens and non-HLA gene polymorphisms in genes controlling immune responses are known to contribute to the risks associated with HSCT. Besides single-nucleotide polymorphisms (SNPs) in protein coding genes, SNPs in regulatory elements such as microRNAs (miRNAs) contribute to these genetic risks. However, genetic risks require for their realization the expression of the respective gene or miRNA. Thus, gene and miRNA expression studies may help to identify genes and SNPs that indeed affect the outcome of HSCT. In this review, we summarize gene expression profiling studies that were performed in recent years in both patients and animal models to identify genes regulated during HSCT. We discuss SNP–mRNA–miRNA regulatory networks and their contribution to the risks associated with HSCT in specific examples, including forkheadbox protein 3 and regulatory T cells, the role of the miR-155 and miR-146a regulatory network for graft-versus-host disease, and the function of MICA and its receptor NKG2D for the outcome of HSCT. These examples demonstrate how SNPs affect expression or function of proteins that modulate the alloimmune response and influence the outcome of HSCT. Specific miRNAs targeting these genes and directly affecting expression of mRNAs are identified. It might be valuable in the future to determine SNPs and to analyze miRNA and mRNA expression in parallel in cohorts of HSCT patients to further elucidate genetic risks of HSCT.
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Affiliation(s)
- Rihab Gam
- Hematological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Pranali Shah
- Institute of Cellular and Molecular Immunology, University Medical Centre Göttingen, Göttingen, Germany
| | - Rachel E Crossland
- Hematological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Jean Norden
- Hematological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Anne M Dickinson
- Hematological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Ralf Dressel
- Institute of Cellular and Molecular Immunology, University Medical Centre Göttingen, Göttingen, Germany
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12
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Tvedt TH, Lie SA, Reikvam H, Rye KP, Lindås R, Gedde-Dahl T, Ahmed AB, Bruserud Ø. Pretransplant Levels of CRP and Interleukin-6 Family Cytokines; Effects on Outcome after Allogeneic Stem Cell Transplantation. Int J Mol Sci 2016; 17:ijms17111823. [PMID: 27809289 PMCID: PMC5133824 DOI: 10.3390/ijms17111823] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 10/22/2016] [Accepted: 10/26/2016] [Indexed: 12/14/2022] Open
Abstract
Several pretransplant factors, including CRP (C-reactive protein) levels, reflect the risk of complications after allogeneic stem cell transplantation. IL-6 induces CRP increase, and we therefore investigated the effects of pretransplant IL-6, soluble IL-6 receptors, IL-6 family cytokines and CRP serum levels on outcome for 100 consecutive allotransplant recipients. All patients had related donors, none had active infections and 99 patients were in complete remission before conditioning. The incidence of acute graft versus host disease (aGVHD) requiring treatment was 40%, survival at Day +100 82%, and overall survival 48%. Despite a significant correlation between pretransplant CRP and IL-6 levels, only CRP levels significantly influenced transplant-related mortality (TRM). However, CRP did not influence overall survival (OS). Pretransplant IL-31 influenced late TRM. Finally, there was a significant association between pretransplant IL-6 and early postconditioning weight gain (i.e., fluid retention), and this fluid retention was a risk factor for aGVHD, TRM and OS. To conclude, pretransplant CRP, IL-31 and early posttransplant fluid retention were independent risk factors for TRM and survival after allotransplantation.
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Affiliation(s)
- Tor Henrik Tvedt
- Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, 5020 Bergen, Norway.
| | - Håkon Reikvam
- Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
- Section for Hematology, Institute of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Kristin Paulsen Rye
- Section for Hematology, Institute of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Roald Lindås
- Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
| | | | - Aymen Bushra Ahmed
- Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
| | - Øystein Bruserud
- Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.
- Section for Hematology, Institute of Clinical Science, University of Bergen, 5020 Bergen, Norway.
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13
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Tootoonchian R, Pak F, Ardekani AM, Sehati N, Abedi-Valugerdi M, Kokhaei P. Evaluation of interleukin 12 and CD56+ lymphocyte cells in pediatric hematopoietic stem cell transplantation for early diagnosis of acute graft versus host disease. Transpl Immunol 2016; 39:25-29. [PMID: 27751764 DOI: 10.1016/j.trim.2016.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/29/2016] [Accepted: 10/14/2016] [Indexed: 11/19/2022]
Abstract
The present study tried to explain CD56+ lymphocyte cells activities and possible prognostic role of these cells in Graft-Versus-Host-Disease (GVHD). The role of IL-12 activation and function is of interest in this study. Peripheral blood samples of 51 Hematopoietic Stem Cell Transplantation (HSCT) recipients collected at before (day -8) and after (days 7 and 14). PBMC were collected by Ficoll separation and analyzed by Flow Cytometry using triple antibody (CD45-PerCP, CD56-FITC, and CD69-PE staining and control antibody. Levels of the cytokine IL-12 in the patient's serum were evaluated by ELISA. Percentage of CD56+ lymphocytes (CD56+bright) cells was significantly increased at day 14 in patients with acute GVHD and percentage of lymphocytes expressing CD69 was significantly increased at days 7 and 14 posts HSCT in patients with acute GVHD in comparison to those in non-GVHD patients. Baseline serum IL-12 levels (pre-HSCT, day -8) were significantly higher in those HSCT recipients who did not develop GVHD. This study showed that post-transplant CD56+ lymphocytes and pre-transplant serum levels of IL-12 play significant roles in the induction of and protection against GVHD, respectively. The increase in the percentage of CD69+ cells indicates the activation of lymphocyte in acute GVHD group.
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Affiliation(s)
- Raziyeh Tootoonchian
- Cancer Research Center, Dept. of Immunology, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Pak
- Cancer Research Center, Dept. of Immunology, Semnan University of Medical Sciences, Semnan, Iran
| | - Ali M Ardekani
- Iran National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran
| | - Nasrin Sehati
- Cancer Research Center, Dept. of Immunology, Semnan University of Medical Sciences, Semnan, Iran
| | - Manuchehr Abedi-Valugerdi
- Experimental Cancer Medicine (ECM), Clinical Research Center (KFC), Novum, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Parviz Kokhaei
- Cancer Research Center, Dept. of Immunology, Semnan University of Medical Sciences, Semnan, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Oncology-Pathology, Immune and Gene Therapy Lab, Cancer Center Karolinska (CCK), Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden.
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14
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Balassa K, Krahling T, Remenyi P, Batai A, Bors A, Kiss KP, Torbagyi E, Gopcsa L, Lengyel L, Barta A, Varga G, Tordai A, Masszi T, Andrikovics H. Recipient and donor JAK2 46/1 haplotypes are associated with acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation. Leuk Lymphoma 2016; 58:391-398. [PMID: 27389386 DOI: 10.1080/10428194.2016.1198956] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Several genetic polymorphisms have been implicated to affect the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT). The role of cytokines in acute graft-versus-host disease (aGvHD) is well established and many of the involved cytokines signal through the Janus kinase (JAK) pathways. In this study, we assessed the association of recipient and donor JAK2 46/1 haplotypes and allo-HSCT outcome in a cohort of 124 acute myeloid leukemia patients. Both, recipient and donor 46/1 haplotypes significantly affected aGvHD grades II-IV development (p = 0.006 and p = 0.031, respectively), furthermore the influence of the haplotypes seemed to be additive. In multivariate analyses the recipient haplotype remained independently related (p = 0.012) to aGvHD, while the donor not (p = 0.08). We observed significantly less relapses among haplotype carriers (p = 0.004), but overall survival did not differ (p = 0.732). Our findings suggest that recipient and donor JAK2 46/1 haplotypes might be involved in the regulation of aGvHD.
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Affiliation(s)
- Katalin Balassa
- a School of PhD Studies , Semmelweis University , Budapest , Hungary.,b Laboratory of Molecular Diagnostics , Hungarian National Blood Transfusion Service , Budapest , Hungary
| | - Tunde Krahling
- a School of PhD Studies , Semmelweis University , Budapest , Hungary.,b Laboratory of Molecular Diagnostics , Hungarian National Blood Transfusion Service , Budapest , Hungary
| | - Peter Remenyi
- c Department of Hematology and Stem Cell Transplantation , St. Istvan and St. Laszlo Hospital , Budapest , Hungary
| | - Arpad Batai
- c Department of Hematology and Stem Cell Transplantation , St. Istvan and St. Laszlo Hospital , Budapest , Hungary
| | - Andras Bors
- b Laboratory of Molecular Diagnostics , Hungarian National Blood Transfusion Service , Budapest , Hungary
| | - Katalin Piroska Kiss
- b Laboratory of Molecular Diagnostics , Hungarian National Blood Transfusion Service , Budapest , Hungary
| | - Eva Torbagyi
- c Department of Hematology and Stem Cell Transplantation , St. Istvan and St. Laszlo Hospital , Budapest , Hungary
| | - Laszlo Gopcsa
- c Department of Hematology and Stem Cell Transplantation , St. Istvan and St. Laszlo Hospital , Budapest , Hungary
| | - Lilla Lengyel
- c Department of Hematology and Stem Cell Transplantation , St. Istvan and St. Laszlo Hospital , Budapest , Hungary
| | - Aniko Barta
- c Department of Hematology and Stem Cell Transplantation , St. Istvan and St. Laszlo Hospital , Budapest , Hungary
| | - Gergely Varga
- d 3rd Department of Internal Medicine , Semmelweis University , Budapest , Hungary
| | - Attila Tordai
- b Laboratory of Molecular Diagnostics , Hungarian National Blood Transfusion Service , Budapest , Hungary.,e Department of Pathophysiology , Semmelweis University , Budapest , Hungary
| | - Tamas Masszi
- c Department of Hematology and Stem Cell Transplantation , St. Istvan and St. Laszlo Hospital , Budapest , Hungary.,d 3rd Department of Internal Medicine , Semmelweis University , Budapest , Hungary
| | - Hajnalka Andrikovics
- b Laboratory of Molecular Diagnostics , Hungarian National Blood Transfusion Service , Budapest , Hungary
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15
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16
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Abstract
For the majority of hematologic malignancies allogeneic hematopoietic cell transplantation (HCT) is the only curative treatment option. Sibling donors have been the standard for adult patients. Since there is not a suitable family donor for all patients, the need for alternative donors for HCT is great. Fortunately, the availability of unrelated volunteer donor registries has expanded over the years and the results of HCT with matched unrelated donors (MUD) are comparable to the results with matched related donors (MRD). Nevertheless, there are many patients lacking a well-matched donor. To increase the applicability of transplantation, alternative donors such as mismatched unrelated donors (MMURD), cord blood stem cell products and haploidentical related donors have been widely used. This review seeks to give insights into the use of MMUD donors for HCT and summarize the existing data.
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Affiliation(s)
- Henning Sebastian Schäfer
- Department of Hematology, Oncology and Stem Cell Transplantation, Albert-Ludwigs University Medical Center, Freiburg, Germany
| | - Jürgen Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Albert-Ludwigs University Medical Center, Freiburg, Germany.
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17
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Risks and Epidemiology of Infections After Hematopoietic Stem Cell Transplantation. TRANSPLANT INFECTIONS 2016. [PMCID: PMC7124050 DOI: 10.1007/978-3-319-28797-3_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Infections following HCT are frequently related to risk factors caused by the procedure itself. Neutropenia and mucositis predispose to bacterial infections. Prolonged neutropenia increases the likelihood of invasive fungal infection. GVHD and its treatment create the most important easily identifiable risk period for a variety of infectious complications, particularly mold infections. Profound, prolonged T cell immunodeficiency, present after T cell-depleted or cord blood transplants, is the main risk factor for viral problems like disseminated adenovirus disease or EBV-related posttransplant lymphoproliferative disorder.
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18
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Laverdière I, Guillemette C, Tamouza R, Loiseau P, Peffault de Latour R, Robin M, Couture F, Filion A, Lalancette M, Tourancheau A, Charron D, Socié G, Lévesque É. Cyclosporine and methotrexate-related pharmacogenomic predictors of acute graft-versus-host disease. Haematologica 2014; 100:275-83. [PMID: 25425682 DOI: 10.3324/haematol.2014.109884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Effective immunosuppression is mandatory to prevent graft-versus-host disease and to achieve a successful clinical outcome of hematopoietic stem cell transplantation. Here we tested whether germline single nucleotide polymorphisms in 20 candidate genes related to methotrexate and cyclosporine metabolism and activity influence the incidence of graft-versus-host disease in patients who undergo stem cell transplantation for hematologic disorders. Recipient genetic status of the adenosine triphosphate-binding cassette sub-family C1 and adenosine triphosphate-binding cassette sub-family C2 transporters, 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/ inosine monophosphate cyclohydrolase within the methotrexate pathway, and nuclear factor of activated T cells (cytoplasmic 1) loci exhibit a remarkable influence on severe acute graft-versus-host disease prevalence. Indeed, an increased risk of acute graft-versus-host disease was observed in association with single nucleotide polymorphisms located in 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/inosine monophosphate cyclohydrolase (hazard ratio=3.04; P=0.002), nuclear factor of activated T cells (cytoplasmic 1) (hazard ratio=2.69; P=0.004), adenosine triphosphate-binding cassette sub-family C2 (hazard ratio=3.53; P=0.0018) and adenosine triphosphate-binding cassette sub-family C1 (hazard ratio=3.67; P=0.0005). While donor single nucleotide polymorphisms of dihydrofolate reductase and solute carrier family 19 (member 1) genes are associated with a reduced risk of acute graft-versus-host disease (hazard ratio=0.32-0.41; P=0.0009-0.008), those of nuclear factor of activated T cells (cytoplasmic 2) are found to increase such risk (hazard ratio=3.85; P=0.0004). None of the tested single nucleotide polymorphisms was associated with the occurrence of chronic graft-versus-host disease. In conclusion, by targeting drug-related biologically relevant genes, this work emphasizes the potential role of germline biomarkers in predicting acute graft-versus-host disease. Further investigations are warranted to improve our understanding of these relationships to personalize immunosuppressive therapy and optimize outcomes.
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Affiliation(s)
- Isabelle Laverdière
- Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval (CHU de Québec) Research Center, Faculty of Pharmacy, Laval University, Québec, Canada
| | - Chantal Guillemette
- Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval (CHU de Québec) Research Center, Faculty of Pharmacy, Laval University, Québec, Canada
| | - Ryad Tamouza
- INSERM UMRS 940, Institut Universitaire d'Hématologie, Université Paris-Diderot and Laboratoire d'Immunologie et d'Histocompatibilité, Hôpital Saint Louis, CIB-HOG, AP-HP, Paris, France
| | - Pascale Loiseau
- INSERM UMRS 940, Institut Universitaire d'Hématologie, Université Paris-Diderot and Laboratoire d'Immunologie et d'Histocompatibilité, Hôpital Saint Louis, CIB-HOG, AP-HP, Paris, France
| | - Regis Peffault de Latour
- Inserm UMRS 940, Institut Universitaire d'Hématologie, Université Paris-Diderot and Service d'Hématologie-Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Marie Robin
- Inserm UMRS 940, Institut Universitaire d'Hématologie, Université Paris-Diderot and Service d'Hématologie-Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Félix Couture
- CHU de Québec Research Center; Faculty of Medicine, Laval University, Québec, Canada
| | - Alain Filion
- CHU de Québec Research Center; Faculty of Medicine, Laval University, Québec, Canada
| | - Marc Lalancette
- CHU de Québec Research Center; Faculty of Medicine, Laval University, Québec, Canada
| | - Alan Tourancheau
- Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval (CHU de Québec) Research Center, Faculty of Pharmacy, Laval University, Québec, Canada
| | - Dominique Charron
- INSERM UMRS 940, Institut Universitaire d'Hématologie, Université Paris-Diderot and Laboratoire d'Immunologie et d'Histocompatibilité, Hôpital Saint Louis, CIB-HOG, AP-HP, Paris, France
| | - Gérard Socié
- Inserm UMRS 940, Institut Universitaire d'Hématologie, Université Paris-Diderot and Service d'Hématologie-Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Éric Lévesque
- CHU de Québec Research Center; Faculty of Medicine, Laval University, Québec, Canada
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19
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Results from a horizon scan on risks associated with transplantation of human organs, tissues and cells: from donor to patient. Cell Tissue Bank 2014; 16:1-17. [DOI: 10.1007/s10561-014-9450-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 04/16/2014] [Indexed: 12/14/2022]
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20
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Risk stratification of organ-specific GVHD can be improved by single-nucleotide polymorphism-based risk models. Bone Marrow Transplant 2014; 49:649-56. [DOI: 10.1038/bmt.2014.20] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 12/20/2013] [Accepted: 01/07/2014] [Indexed: 12/13/2022]
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21
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Iravani-Saadi M, Karimi MH, Yaghobi R, Geramizadeh B, Ramzi M, Niknam A, Pourfathollah A. Polymorphism of costimulatory molecules (CTLA4, ICOS, PD.1 and CD28) and allogeneic hematopoietic stem cell transplantation in Iranian patients. Immunol Invest 2014; 43:391-404. [DOI: 10.3109/08820139.2013.879594] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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22
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Multiple Single-Nucleotide Polymorphism–Based Risk Model for Clinical Outcomes After Allogeneic Stem-Cell Transplantation, Especially for Acute Graft-Versus-Host Disease. Transplantation 2012; 94:1250-7. [DOI: 10.1097/tp.0b013e3182708e7c] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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23
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Sharp H, Grosshans D, Kadia T, Dabaja BS. Cutaneous graft-versus-host disease after proton-based craniospinal irradiation for recurrent Philadelphia-positive acute lymphoblastic leukaemia. BMJ Case Rep 2012; 2012:bcr.02.2012.5742. [PMID: 22787181 DOI: 10.1136/bcr.02.2012.5742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Treatment of recurrent acute lymphoblastic leukaemia (ALL) often involves allogeneic stem-cell transplantation (alloSCT) and disease recurrence in the central nervous system may require craniospinal irradiation. Although graft-versus-host disease (GVHD) is a known risk after alloSCT, cutaneous manifestation within radiation fields is rarely seen. The authors report a case of a 25-year-old man with Philadelphia+ALL recurring in the central nervous system after a homologous SCT. Craniospinal radiation was delivered with proton therapy to a total dose of 24 cobalt-Gray-equivalents in 12 fractions. Eight weeks after the proton therapy, significant cutaneous GVHD had developed within the radiation fields. This was treated successfully with tacrolimus (4 mg/day), a short course of methylprednisolone, and topical treatment with 0.1% triamcinolone cream, 0.05% clobetasol ointment. Cutaneous GVHD after SCT can be seen within proton radiation fields probably due to an inherent higher skin dose.
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Affiliation(s)
- Hadley Sharp
- Radiation Oncology, UT MD Anderson Cancer Center, Houston, Texas, USA
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24
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Pearce KF, Lee SJ, Haagenson M, Petersdorf EW, Norden J, Collin MP, Klein JP, Spellman SR, Lowerson SA, Davies S, Dickinson AM. Analysis of non-HLA genomic risk factors in HLA-matched unrelated donor hematopoietic cell transplantation for chronic myeloid leukemia. Haematologica 2012; 97:1014-9. [PMID: 22271889 DOI: 10.3324/haematol.2011.053611] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Allogeneic hematopoietic cell transplantation is the main curative therapy for patients with chronic myeloid leukemia who do not respond to tyrosine kinase inhibitors. It has been proposed that non-human leukocyte antigen gene polymorphisms influence outcome after hematopoietic cell transplantation and could be used alongside traditional patient-donor and transplant characteristics to create a recipient risk profile associated with allogeneic hematopoietic cell transplantation. DESIGN AND METHODS A previous study from the European Group for Blood and Marrow Transplantation showed that the absence of recipient tumor necrosis factor receptor II, absence of donor interleukin 10 ATA/ACC and presence of donor interleukin 1 receptor antagonist allele 2 genotypes were associated with decreased survival and increased non-relapse mortality in adult patients with chronic myeloid leukemia undergoing myeloablative human leukocyte antigen-identical sibling transplantation. To explore these associations in unrelated donor transplantation, these polymorphisms were genotyped in 383 adult patients with chronic myeloid leukemia who underwent hematopoietic cell transplantation from unrelated donors matched for 10/10 human leukocyte antigens. RESULTS The polymorphisms were not associated with overall survival, non-relapse mortality, relapse or acute graft-versus-host disease in the unrelated donor cohort. Comparison of the unrelated donor and human leukocyte antigen-identical sibling cohorts showed differences in survival and clinical characteristics. CONCLUSIONS We did not confirm that non-human leukocyte antigen polymorphisms were associated with outcomes in myeloablative unrelated donor hematopoietic cell transplantation for chronic myeloid leukemia, possibly because of the strong association between clinical variables and outcome which masked more subtle genetic effects.
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Affiliation(s)
- Kim F Pearce
- Haematological Sciences, Institute of Cellular Medicine, William Leech Building, Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
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25
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Pan B, Zeng L, Cheng H, Song G, Chen C, Zhang Y, Li Z, Xu K. Altered balance between Th1 and Th17 cells in circulation is an indicator for the severity of murine acute GVHD. Immunol Lett 2012; 142:48-54. [PMID: 22249079 DOI: 10.1016/j.imlet.2011.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 12/14/2011] [Accepted: 12/20/2011] [Indexed: 10/14/2022]
Abstract
Disbalance of Th1 and Th17 can lead to inflammatory diseases and autoimmunity. Acute graft-versus-host disease (GVHD) is now considered as a compound and dysregulated immune response. Both Th1 and Th17 have been implicated in the pathophysiology of acute GVHD. Disbalance of Th1 and Th17 may also play a critical role in mediating acute GVHD. In this study, we investigated the Th1/Th17 imbalance in peripheral blood through out the pathological process of acute GVHD, using a GVHD model of C57BL/6 (H-2(b)) donor to BALB/c (H-2(d)) recipient. We also analyzed the correlation between Th1/Th17 ratio and severity of acute GVHD, and explored the potential function of Th1/Th17 imbalance in acute GVHD. Recipients received 5×10(6) spleen cells (SP) underwent more severe acute GVHD, compared with the ones received 5×10(5) SP. Severe GVHD bearing recipients had much higher proportion of Th1 cells but lower proportion of Th17 cells, compared with mild GVHD bearing ones. The Th1/Th17 ratios in both groups underwent relative changes according to the changing proportions of Th1 and Th17 cells and showed positive correlation with clinical scores of acute GVHD. We describe the changing proportions of Th1 and Th17 cells in acute GVHD, and we find that Th1/Th17 ratio is an accurate indicator for predicting the severity of acute GVHD.
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Affiliation(s)
- Bin Pan
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, China
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26
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Cardozo DM, Lieber SR, Marques SBD, Aranha FJ, Vigorito AC, de Souza CA, Visentainer JEL. Association between human leukocyte antigens and graft-versus-host disease occurrence after allogenic hematopoietic stem cell transplantation. SAO PAULO MED J 2012; 130:219-24. [PMID: 22965361 PMCID: PMC10619959 DOI: 10.1590/s1516-31802012000400003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 12/19/2011] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Graft-versus-host disease (GVHD) is one of the complications following allogenic stem cell transplantation. This study investigated an association between human leukocyte antigen (HLA) and the occurrence of acute and chronic GVHD in patients who had received stem cell transplantations from HLA-identical siblings. DESIGN AND SETTING Retrospective study at Hematology and Hemotherapy Center, Universidade Estadual de Campinas (Unicamp). METHODS The participants were 176 patients whose first transplant was between 1997 and 2009. HLA genotyping was performed serologically and using the polymerase chain reaction with specific primer sequence. RESULTS Acute GVHD was positively associated with HLA-A10 (P = 0.0007), HLA-A26 (P = 0.002), B55 (P = 0.001), DRB1*15 (P = 0.0211) and DQB1*05 (P = 0.038), while HLA-B16 (P = 0.0333) was more frequent in patients without acute GVHD. Chronic GVHD was positively associated with HLA-A9 (P = 0.01) and A23 (P = 0.0292) and negatively with HLA-A2 (P = 0.0031) and B53 (P = 0.0116). HLA-B35 (P = 0.0373), B49 (P = 0.0155) and B55 (P = 0.0024) were higher in patients with acute GVHD grade 3 or above, than in other patients. In patients with extensive chronic GVHD, HLA-A9 (P = 0.0004), A24 (P = 0.0059) and A26 (P = 0.0411) were higher than in other patients, while HLA-A2 was lower (P = 0.0097). CONCLUSION This study suggests that HLA can influence the incidence and severity of acute and chronic GVHD. However, a study with a better design and more patients will be needed to confirm these results.
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Affiliation(s)
- Daniela Máira Cardozo
- MSc. Doctoral Student in Clinical Medicine, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Sofia Rocha Lieber
- MSc, PhD. Biomedic, HLA Laboratory, Hematology and Hemotherapy Center, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Silvia Barbosa Dutra Marques
- MSc. Supervisor, HLA Laboratory, Hematology and Hemotherapy Center, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Francisco José Aranha
- MD, PhD. Hematologist, Hematology and Hemotherapy Center, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Afonso Celso Vigorito
- MD, PhD. Hematologist, Hematology and Hemotherapy Center, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Cármino Antonio de Souza
- MD, PhD. Titular Professor, Hematology and Hemotherapy Center, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Jeane Eliete Laguila Visentainer
- MSc, PhD. Adjunct Professor, Department of Basic Health Science, Universidade Estadual de Maringá (UEM), Maringá, Paraná, Brazil.
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27
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Boukouaci W, Busson M, Fortier C, Amokrane K, de Latour RP, Robin M, Krishnamoorthy R, Toubert A, Charron D, Socié G, Tamouza R. Association of HLA-G low expressor genotype with severe acute graft-versus-host disease after sibling bone marrow transplantation. Front Immunol 2011; 2:74. [PMID: 22566863 PMCID: PMC3342264 DOI: 10.3389/fimmu.2011.00074] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 11/25/2011] [Indexed: 11/13/2022] Open
Abstract
Background: Human leukocyte antigen-G (HLA-G) molecules play a prominent role in immune tolerance. Structurally similar to their classical HLA homologs, they are distinct by having high rate of polymorphism in the non-coding regions including a functionally relevant 14-base pair (bp) insertion/deletion (Ins/Del) allele in the 3′ untranslated region (3′UTR), rarely examined in a hematopoietic stem cell transplantation (HSCT) setting. Here, we analyzed the potential impact of HLA-G Ins/Del dimorphism on the incidence of acute graft-versus-host disease (aGvHD), transplant-related mortality (TRM), overall survival (OS), and incidence of relapse after HSCT using bone marrow (BM) as stem cell source from HLA-matched donors. Methods: One hundred fifty-seven sibling pairs, who had undergone HSCT, were studied for the distribution of the HLA-G 14 bp Ins/Del polymorphism using a polymerase chain reaction (PCR)-based technique. Potential genetic association with the incidence of aGvHD, TRM, and OS was analyzed by monovariate and multivariate analyses. Results: Monovariate analysis showed that the homozygous state for the 14-bp Ins allele is a risk factor for severe aGvHD (grade III and IV; P = 0.008), confirmed subsequently by multivariate analysis [hazard ratio (HR) = 3.5; 95% confidence interval (95%CI) = 1.3–9.5; P = 0.012]. We did not find any association between HLA-G polymorphism and the other studied complications. Conclusion: Our data suggest that the HLA-G low expressor 14 bp Ins allele constitutes a risk factor for the incidence of severe aGvHD in patients who received BM as stem cell source.
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Affiliation(s)
- Wahid Boukouaci
- Laboratoire d'Immunologie et d'Histocompatibilité and INSERM, UMRS 940, Hôpital Saint-Louis Paris, France
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Pidala J. Graft-vs-Host Disease following Allogeneic Hematopoietic Cell Transplantation. Cancer Control 2011; 18:268-76. [DOI: 10.1177/107327481101800407] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative therapy with proven efficacy in the management of hematologic malignancies. However, it is complicated by the syndromes of acute and chronic graft-vs-host disease (GVHD). Methods A narrative review is provided to summarize major biologic insights into the pathogenesis of these immune-mediated disorders, as well as advances in diagnosis, classification, prevention, management, and allied supportive care with the aim of providing essential understanding for clinicians with or without subspecialty experience in the field of blood and marrow transplantation. Results Major scientific advances have contributed to enhanced understanding of the pathogenesis of these disorders, and clinical investigation has provided more effective preventive and therapeutic strategies for GVHD. However, since acute GVHD and chronic GVHD remain leading sources of transplantation-related morbidity and mortality, ongoing investigation is needed to develop new approaches to addressing these syndromes. Conclusions The major challenge for future investigation will be to capitalize on biologic insights in order to develop novel strategies for the prevention and therapy of acute and chronic GVHD that will address the current shortcomings in existing therapeutic approaches.
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Affiliation(s)
- Joseph Pidala
- H. Lee Moffitt Cancer Center & Research Institute and the Department of Oncologic Sciences at the University of South Florida College of Medicine, Tampa, Florida
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HU STEPHANIEW, COTLIAR JONATHAN. Acute graft-versus-host disease following hematopoietic stem-cell transplantation. Dermatol Ther 2011; 24:411-23. [DOI: 10.1111/j.1529-8019.2011.01436.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
Displaying the highest level of diversity of any functional genetic complex with medical impact, the HLA system represents a landmark and a model for the development of predictive and preventive medicine. The massive amount of data which will soon be obtained through new high through put technologies for individual genomes and transcriptomes challenges the HLA and medicine paradigm. Systems biology approach and integrative methodologies will undoubtedly be needed to unravel the ever growing number of HLA and diseases associations and the role of immunogenetics in transplantation and other allogeneic cell therapies. Also HLA, immunogenetics and pharmacogenetics are merging to bring to the individual patient tailored and personalized treatment. Providing insights into the complexities of predictive, preventive participatory and personalized medicine, the role of the HLA system will be consolidated at the forefront of the newer medicine.
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Affiliation(s)
- D Charron
- Immunology, Inserm 940-IUH-Hopital Saint-Louis, Paris, France.
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Cytokine gene polymorphisms and graft-versus-host disease in children after matched sibling hematopoietic stem cell transplantation: a single-center experience. Cell Mol Immunol 2011; 8:276-80. [PMID: 21358669 DOI: 10.1038/cmi.2011.4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Various polymorphisms in cytokine genes have recently been investigated as candidate risk factors in allogeneic hematopoetic stem cell transplantation (allo-HSCT). We retrospectively analyzed specific polymorphisms in genes for interleukin (IL)-10, IL-6, tumor-necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) in a pediatric cohort of 57 histocompatibility leucocyte antigen (HLA)-identical sibling myeloablative transplants. Both recipient and donor genotypes were tested for association with graft-versus-host disease (GVHD) by statistical methods including Cox regression analysis. We found a significant association between the IL-10 promoter haplotype polymorphisms at positions -1082, -819 and -592 with the occurrence of severe (grades III-IV) acute GVHD (aGVHD). Recipients with the haplotype GCC had a statistically significant decreased risk of severe aGVHD (hazard risk (HR)=0.20, 95% confidence interval (CI): 0.06-0.67) in comparison with patients with other IL-10 haplotypes (P=0.008). Transplant-related mortality at 1 year was significantly lower in recipients with this haplotype (HR=0.17, 95% CI: 0.012-0.320) versus other IL-10 haplotypes (P=0.03), whereas overall survival was not influenced by IL-10 haplotype polymorphisms. In multivariate analysis, the presence of the IL-10 GCC haplotype was found as the only variable associated with a statistically significant decreased hazard of severe aGVHD development (P=0.02, HR=0.21, 95% CI: 0.05-0.78). These results suggest that pediatric patients possessing the IL-10 GCC haplotype may be protected from the occurrence of severe aGVHD in the setting of matched sibling HSCT.
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Georgoudaki AM, Sutlu T, Alici E. Suicide gene therapy for graft-versus-host disease. Immunotherapy 2010; 2:521-37. [PMID: 20636006 DOI: 10.2217/imt.10.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In allogeneic hematopoietic stem cell transplantation, donor-derived T cells are key players for early immune reconstitution and efficient engraftment, as well as the graft-versus-leukemia and graft-versus-infection effects. However, a severe and quite common life-threatening complication is the development of graft-versus-host disease, during which the alloreactive donor T cells attack the host. Controlling graft-versus-host disease while preserving the benefits of graft-versus-leukemia still constitutes a challenge. A promising approach for the control of graft-versus-host disease is suicide gene therapy, which involves the ex vivo genetic modification of donor T cells with a suicide gene that allows for the selective elimination of the cells in vivo if graft-versus-host disease occurs. This article presents an overview of such approaches with special reference to lessons learned from previous clinical experiences, as well as a discussion of critical factors in suicide gene therapy.
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Auffray C, Charron D, Hood L. Predictive, preventive, personalized and participatory medicine: back to the future. Genome Med 2010; 2:57. [PMID: 20804580 PMCID: PMC2945014 DOI: 10.1186/gm178] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The pioneering work of Jean Dausset on the HLA system established several principles that were later reflected in the Human Genome Project and contributed to the foundations of predictive, preventive, personalized and participatory (P4) medicine. To effectively develop systems medicine, we should take advantage of the lessons of the HLA saga, emphasizing the importance of exploring a fascinating but mysterious biology, now using systems principles, pioneering new technology developments and creating shared biological and information resources.
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Affiliation(s)
- Charles Auffray
- Functional Genomics and Systems Biology for Health, CNRS Institute of Biological Sciences, 7 rue Guy Moquet, BP8, 94801 Villejuif cedex, France.
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Choi SW, Levine JE, Ferrara JLM. Pathogenesis and management of graft-versus-host disease. Immunol Allergy Clin North Am 2010; 30:75-101. [PMID: 20113888 DOI: 10.1016/j.iac.2009.10.001] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is an important therapeutic option for various malignant and nonmalignant conditions. As allogeneic HCT continues to increase, greater attention is given to improvements in supportive care, infectious prophylaxis, immunosuppressive medications, and DNA-based tissue typing. However, graft versus host disease (GVHD) remains the most frequent and serious complication following allogeneic HCT and limits the broader application of this important therapy. Recent advances in the understanding of the pathogenesis of GVHD have led to new approaches to its management, including using it to preserve the graft versus leukemia effect following allogeneic transplant. This article reviews the important elements in the complex immunologic interactions involving cytokine networks, chemokine gradients, and the direct mediators of cellular cytotoxicity that cause clinical GVHD, and discusses the risk factors and strategies for management of GVHD.
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Affiliation(s)
- Sung W Choi
- Department of Pediatrics, Blood and Marrow Transplant Program, University of Michigan Medical School, 1500 E. Medical Center Drive, 6303 Comprehensive Cancer Center, Ann Arbor, MI 48109-5942, USA.
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Abstract
Graft-versus-host disease (GVHD) is a frequent complication after hematopoietic cell transplant (HCT). Tissue damage as a result of chemoradiation injury is the initiating event in the pathogenesis of acute GVHD. Variations in DNA repair can influence the amount of tissue damage in response to alkylating agents and ionizing radiation used as conditioning during HCT. As DNA damage caused by these agents is repaired by the base excision repair (BER) pathway, we hypothesized that single-nucleotide polymorphisms (SNPs) in BER pathway will be associated with GVHD after HCT. Hence, we analyzed 179 SNPs in BER pathway in 470 recipients of allogeneic HCT for association with acute and chronic GVHD. In multivariate analysis, one SNP (rs6844176) in RFC1 (replication factor C (activator 1)) gene was independently associated with a higher risk of grade II-IV acute GVHD (relative risk (RR): 1.39, 95% confidence interval (CI): 1.14-1.70, P=0.001), and showed a trend toward higher risk of grade III-IV acute GVHD (RR: 1.33, 95% CI: 0.95-1.85, P=0.09). One SNP in PARP1 gene (rs1805410) was associated with a higher risk of chronic GVHD (RR: 1.81, 95% CI: 1.29-2.54, P=0.001). These results show that SNPs in the BER pathway can be used as genetic biomarkers to predict those at high risk for GVHD toward whom novel prophylactic strategies could be targeted.
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Shaw BE, Arguello R, Garcia-Sepulveda CA, Madrigal JA. The impact of HLA genotyping on survival following unrelated donor haematopoietic stem cell transplantation. Br J Haematol 2010; 150:251-8. [DOI: 10.1111/j.1365-2141.2010.08224.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dickinson AM, Pearce KF, Norden J, O'Brien SG, Holler E, Bickeböller H, Balavarca Y, Rocha V, Kolb HJ, Hromadnikova I, Sedlacek P, Niederwieser D, Brand R, Ruutu T, Apperley J, Szydlo R, Goulmy E, Siegert W, de Witte T, Gratwohl A. Impact of genomic risk factors on outcome after hematopoietic stem cell transplantation for patients with chronic myeloid leukemia. Haematologica 2010; 95:922-7. [PMID: 20305143 PMCID: PMC2878789 DOI: 10.3324/haematol.2009.016220] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 12/07/2009] [Accepted: 12/10/2009] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Non-HLA gene polymorphisms have been shown to influence outcome after allogeneic hematopoietic stem cell transplantation. Results were derived from heterogeneous, small populations and their value remains a matter of debate. DESIGN AND METHODS In this study, we assessed the effect of single nucleotide polymorphisms in genes for interleukin 1 receptor antagonist (IL1RN), interleukin 4 (IL4), interleukin 6 (IL6), interleukin 10 (IL10), interferon (IFNG), tumor necrosis factor (TNF) and the cell surface receptors tumor necrosis factor receptor II (TNFRSFIB), vitamin D receptor (VDR) and estrogen receptor alpha (ESR1) in a homogeneous cohort of 228 HLA identical sibling transplants for chronic myeloid leukemia. Three good predictors of overall survival, identified via statistical methods including Cox regression analysis, were investigated for their effects on transplant-related mortality and relapse. Predictive power was assessed after integration into the established European Group for Blood and Marrow Transplantation (EBMT) risk score. RESULTS Absence of patient TNFRSFIB 196R, absence of donor IL10 ATA/ACC and presence of donor IL1RN allele 2 genotypes were associated with increased transplantation-related mortality and decreased survival. Application of prediction error and concordance index statistics gave evidence that integration improved the EBMT risk score. CONCLUSIONS Non-HLA genotypes were associated with survival after allogeneic hematopoietic stem cell transplantation. When three genetic polymorphisms were added into the EBMT risk model they improved the goodness of fit. Non-HLA genotyping could, therefore, be used to improve donor selection algorithms and risk assessment prior to allogeneic hematopoietic stem cell transplantation.
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MESH Headings
- Adolescent
- Adult
- Cohort Studies
- Cytokines/genetics
- Female
- Genomic Instability
- Genotype
- Graft vs Host Disease/genetics
- Graft vs Host Disease/mortality
- Hematopoietic Stem Cell Transplantation/adverse effects
- Hematopoietic Stem Cell Transplantation/mortality
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/surgery
- Male
- Middle Aged
- Polymorphism, Single Nucleotide/genetics
- Prospective Studies
- Risk Factors
- Survival Rate/trends
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Anne M Dickinson
- Haematological Sciences, Institute of Cellular Medicine, Newcastle University, UK.
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Goddard DS, Horn BN, McCalmont TH, Cordoro KM. Clinical Update on Graft-Versus-Host Disease in Children. ACTA ACUST UNITED AC 2010; 29:92-105. [DOI: 10.1016/j.sder.2010.03.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Westekemper H, Meller S, Citak S, Schulte C, Steuhl KP, Homey B, Meller D. Differential chemokine expression in chronic GVHD of the conjunctiva. Bone Marrow Transplant 2010; 45:1340-6. [PMID: 20140022 DOI: 10.1038/bmt.2009.346] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In chronic GVHD after BMT, the conjunctiva represents a target organ. GVHD can lead to severe inflammation and dry-eye syndrome (sicca syndrome). The molecular mechanisms are largely unknown. We examined the expression of chemokines in the conjunctiva in cases of chronic GVHD. In this study, we included 10 patients with chronic GVHD and 10 healthy controls. Clinical data were collected and tear film analysis and conjunctival cytology were carried out. Conjunctival biopsies were taken from all participants. Gene expression profiles of chemokines and their corresponding receptors were evaluated by means of quantitative real-time PCR. Chemokine protein expression was analysed by immunohistochemical analyses. Expressions of the Th1-associated chemokines, chemokine (C-X-C motif) ligand (CXCL) 9 (Mig), CXCL10 (IP-10), and their receptor chemokine (C-X-C motif) receptor 3 (CXCR3) were significantly increased in GVHD patients. Immunohistochemical analysis confirmed marked expression of the inflammatory CXCR3 ligands. A total of six patients had a moderate or severe sicca syndrome. Impression cytology revealed a mild keratinisation, moderate keratinisation or severe squamous metaplasia in three patients, respectively. Chronic GVHD of the conjunctiva is characterised by the expression of Th1-associated chemokines. Taken together, our results confirm that the conjunctiva is a target organ in this T cell-mediated process and add to molecular understanding of conjunctival GVHD.
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Affiliation(s)
- H Westekemper
- Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
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41
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Ludajic K, Balavarca Y, Bickeböller H, Rosenmayr A, Fischer GF, Faé I, Kalhs P, Pohlreich D, Kouba M, Dobrovolna M, Greinix HT. Minor ABO-mismatches are risk factors for acute graft-versus-host disease in hematopoietic stem cell transplant patients. Biol Blood Marrow Transplant 2009; 15:1400-6. [PMID: 19822299 DOI: 10.1016/j.bbmt.2009.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Accepted: 07/06/2009] [Indexed: 11/17/2022]
Abstract
We investigated the impact of ABO and Rhesus (Rh) blood group matching on the outcome of hematopoietic stem cell transplantation (HSCT) of 154 patients matched at 10/10 HLA loci with unrelated donors. ABO and Rh, as potential risk factors, were modeled with the clinical outcome--acute and chronic graft-versus-host disease (aGVHD, cGVHD), relapse, treatment-related mortality (TRM), and overall survival (OS)--by simple, multiple, and competing risk analyses. We found that minor ABO-mismatches represent a significant risk factor for aGVHD (II-IV) with an estimated risk increase of almost 3-fold (hazard ratio [HR]=2.92, 95% confidence interval [CI]: 1.43-5.95, P=.003), and even 4-fold for aGVHD (III-IV) (HR=4.24, 95% CI: 1.70-10.56, P=.002), but not for other transplant endpoints. No significant association of the Rh matching status with any of the HSCT endpoints was seen. These results suggest that ABO minor mismatches may play a role in aGvHD pathophysiology, possibly by providing the setting for T cell activation and antibody mediated damage. To decrease the risk of aGVHD, ABO matching should be considered in HSCT.
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Affiliation(s)
- Katarina Ludajic
- Division of Blood Group Serology, Medical University of Vienna, Austria
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42
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Khaled Y, Reddy P, Krijanovski O. Emerging drugs for acute graft-versus-host disease. Expert Opin Emerg Drugs 2009; 14:219-32. [PMID: 19519285 DOI: 10.1517/14728210903018891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The number of allogeneic hematopoietic cell transplantations (HCT) continues to increase. More than 15,000 allogeneic transplantations are performed annually. The graft-versus-leukemia/tumor effect during allogeneic HCT effectively eradicates many hematological malignancies. The development of novel strategies that use donor leukocyte infusions, nonmyeloablative conditioning and umbilical cord blood transplantation have helped expand the indications for allogeneic HCT over the past several years, especially among older patients. Yet the major complication of allogeneic HCT, graft-versus-host disease, remains lethal and limits wider application of allogeneic HCT. In this article, we review current practice and recent advances made in prevention and treatment of graft-versus-host disease.
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Affiliation(s)
- Yasser Khaled
- The University of Michigan, 1500 East Medical Center Drive, SPC 5942, 6310 Comprehensive Cancer Center, Ann Arbor, MI 48109-0942, USA
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43
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Davies SM, Dickinson A, Miller JS. Human polymorphism and variable outcomes of cancer chemotherapy and transplantation. Biol Blood Marrow Transplant 2009; 14:120-8. [PMID: 18162232 DOI: 10.1016/j.bbmt.2007.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Stella M Davies
- Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA
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Barkholt L. Importance of CsA drug monitoring in SCT recipients to minimize GVHD and maximize graft vs. leukemia. Pediatr Transplant 2009; 13:400-3. [PMID: 18992059 DOI: 10.1111/j.1399-3046.2008.01057.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Haemopoietic-cell transplantation (HCT) is an intensive therapy used to treat high-risk haematological malignant disorders and other life-threatening haematological and genetic diseases. The main complication of HCT is graft-versus-host disease (GVHD), an immunological disorder that affects many organ systems, including the gastrointestinal tract, liver, skin, and lungs. The number of patients with this complication continues to grow, and many return home from transplant centres after HCT requiring continued treatment with immunosuppressive drugs that increases their risks for serious infections and other complications. In this Seminar, we review our understanding of the risk factors and causes of GHVD, the cellular and cytokine networks implicated in its pathophysiology, and current strategies to prevent and treat the disease. We also summarise supportive-care measures that are essential for management of this medically fragile population.
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Affiliation(s)
- James L M Ferrara
- University of Michigan, Pediatrics and Internal Medicine, Blood and Marrow Transplantation Program, Ann Arbor, MI 48109-5942, USA.
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Ambruzova Z, Mrazek F, Raida L, Stahelova A, Faber E, Indrak K, Petrek M. Possible impact of MADCAM1 gene single nucleotide polymorphisms to the outcome of allogeneic hematopoietic stem cell transplantation. Hum Immunol 2009; 70:457-60. [PMID: 19286444 DOI: 10.1016/j.humimm.2009.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 02/19/2009] [Accepted: 03/02/2009] [Indexed: 11/16/2022]
Abstract
Mucosal addressin cell adhesion molecule-1 (MAdCAM-1) contributes to the recruitment of donor T cells into the mucosal tissues of the recipient after allogeneic hematopoietic stem cell transplantation (aHSCT). The aim of our study was to determine whether selected single nucleotide polymorphisms (SNPs) of the MADCAM1 gene are associated with development of serious complications after aHSCT. Three MADCAM1 gene single nucleotide polymorphisms (rs758502 C/T, rs2302217 A/G, rs3745925 G/T) were genotyped by polymerase chain reaction with sequence-specific primers in 87 Czech, HLA-identical donor-recipient aHSCT pairs. MADCAM1 rs2302217 AA homozygous recipients developed chronic GVHD more frequently than patients with other genotypes (65% vs. 34%; p = 0.025). Furthermore, multivariate analysis revealed the MADCAM1 rs2302217 AA genotype in recipient being also an independent factor associated with development of acute GVHD (p = 0.036) and decreased overall survival (p = 0.001). These data suggest that MADCAM1 gene polymorphisms may be associated with the risk of chronic GVHD and may, also, affect mortality related to aHSCT.
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Affiliation(s)
- Zuzana Ambruzova
- Laboratory of Immunogenomics and Proteomics, Department of Immunology, Palacky University and University Hospital, Olomouc, Czech Republic
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Ambruzova Z, Mrazek F, Raida L, Faber E, Onderkova J, Kriegova E, Indrak K, Petrek M. Association of IL-6 gene polymorphism with the outcome of allogeneic haematopoietic stem cell transplantation in Czech patients. Int J Immunogenet 2009; 35:401-3. [PMID: 18976446 DOI: 10.1111/j.1744-313x.2008.00798.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Interleukin-6 (IL-6) is an important pro-inflammatory mediator implicated in immune-mediated complications of allogeneic haematopoietic stem cell transplantation (aHSCT). In accord with previous reports, this preliminary study on 56 donor-recipient pairs revealed IL-6-174 single nucleotide polymorphisms as a risk factor for the development of acute graft-versus-host disease and decreased survival after aHSCT.
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Affiliation(s)
- Z Ambruzova
- Department of Immunology, Tissue Typing Laboratory, Palacky University Olomouc, Czech Republic
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48
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Ambruzova Z, Mrazek F, Raida L, Jindra P, Vidan-Jeras B, Faber E, Pretnar J, Indrak K, Petrek M. Association of IL6 and CCL2 gene polymorphisms with the outcome of allogeneic haematopoietic stem cell transplantation. Bone Marrow Transplant 2009; 44:227-35. [PMID: 19234509 DOI: 10.1038/bmt.2009.16] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Various polymorphisms of non-HLA genes have recently been investigated as candidate risk factors in allogeneic haematopoietic SCT (aHSCT). Our study aimed at exploring possible associations of IL6 and CCL2 single nucleotide polymorphisms (SNP) with aHSCT outcome. A total of 166 HLA-identical aHSCT pairs recruited in were genotyped for IL6 -174 G/C, IL6 -597 G/A, CCL2 -2518 A/G and CCL2 -2076 A/T SNPs by PCR with sequence-specific primers (PCR-SSP). The association between IL6 -174 GG genotype and increased risk of acute GVHD was found in whole study group (P=0.03) and in the subgroup of related aHSCT (P=0.01), association between IL6 -597 GG genotype and the occurrence of acute GVHD was detected only in the related aHSCT pairs (P=0.02). Furthermore, reduction in OS was revealed among recipients possessing IL6 -174(*)G allele in the group of related aHSCT pairs (P=0.04). Presence of CCL2 -2076 TT genotype was associated with decrease of OS (P=0.04) and increase of TRM (P=0.02) in patients transplanted by related donor. These results, in the context of previous findings, suggest that IL6 gene polymorphisms may be associated with aHSCT outcome, particularly in patients transplanted from a related donor.
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Affiliation(s)
- Z Ambruzova
- Department of Immunology, Palacky University and University Hospital, Olomouc, Czech Republic
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Clinical and Prognostic Value of Discrepancies in Microsatellite DNA Regions Between Recipient and Donor in Human Leukocyte Antigen-Identical Allogeneic Transplantation Setting. Transplantation 2008; 86:983-90. [DOI: 10.1097/tp.0b013e318183ee2a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Charron D, Suberbielle-Boissel C, Al-Daccak R. Immunogenicity and Allogenicity: A Challenge of Stem Cell Therapy. J Cardiovasc Transl Res 2008; 2:130-8. [DOI: 10.1007/s12265-008-9062-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 09/08/2008] [Indexed: 12/18/2022]
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