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Crocchiolo R, Rombolà G. Human Leucocyte Antigen System and Selection of Unrelated Hematopoietic Stem Cell Donors: Impact of Patient-Donor (Mis)matching and New Challenges with the Current Technologies. J Clin Med 2023; 12:jcm12020646. [PMID: 36675576 PMCID: PMC9862309 DOI: 10.3390/jcm12020646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
The selection of hematopoietic stem cell donors for allogeneic transplantation (allo-HSCT) is mainly driven by human leucocyte antigen (HLA) matching between patient and donor, with HLA-identical matched siblings being the preferred choice in most situations. Although other clinical and demographical variables matter, especially, donor age, which is unequivocally associated with better transplant outcomes, the histocompatibility criteria have a central role in the search for the best donor, particularly in the setting of unrelated allo-HSCT where HLA disparities between patient and donor are frequent. The present review is focused on the role of HLA incompatibilities on patient outcome according to the most recent literature, in an attempt to guide transplant physicians and search coordinators during the process of adult unrelated-donor selection. The technological progresses in HLA typing, i.e., with next-generation sequencing (NGS), now allow disclosing a growing number of HLA incompatibilities associated with a heterogeneous and sometimes unknown spectrum of clinical severity. Their immunogenic characteristics, i.e., their position inside or outside the antigen recognition domain (ARD), their permissiveness, their intronic or exonic nature and even the expected expression of the HLA loci where those mismatches occur, will be presented and discussed here, integrating the advances in the immunobiology of transplantation with survival and toxicity outcomes reported in the most relevant studies, within the perspective of improving donor selection in the current practice.
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Affiliation(s)
- Roberto Crocchiolo
- Servizio di Immunoematologia e Medicina Trasfusionale, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore, 3, 20162 Milano, Italy
- Correspondence: ; Tel.: +39-02-64443962
| | - Gianni Rombolà
- Laboratory of Immunogenetics and Transplant Immunology, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy
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Bettens F, Calderin Sollet Z, Buhler S, Villard J. CD8+ T-Cell Repertoire in Human Leukocyte Antigen Class I-Mismatched Alloreactive Immune Response. Front Immunol 2021; 11:588741. [PMID: 33552048 PMCID: PMC7856301 DOI: 10.3389/fimmu.2020.588741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/26/2020] [Indexed: 11/13/2022] Open
Abstract
In transplantation, direct allorecognition is a complex interplay between T-cell receptors (TCR) and HLA molecules and their bound peptides expressed on antigen-presenting cells. In analogy to HLA mismatched hematopoietic stem cell transplantation (HSCT), the TCR CDR3β repertoires of alloreactive cytotoxic CD8+ responder T cells, defined by the cell surface expression of CD137 and triggered in vitro by HLA mismatched stimulating cells, were analyzed in different HLA class I mismatched combinations. The same HLA mismatched stimulatory cells induced very different repertoires in distinct but HLA identical responders. Likewise, stimulator cells derived from HLA identical donors activated CD8+ cells expressing very different repertoires in the same mismatched responder. To mimic in vivo inflammation, expression of HLA class l antigens was upregulated in vitro on stimulating cells by the inflammatory cytokines TNFα and IFNβ. The repertoires differed whether the same responder cells were stimulated with cells treated or not with both cytokines. In conclusion, the selection and expansion of alloreactive cytotoxic T-cell clonotypes expressing a very diverse repertoire is observed repeatedly despite controlling for HLA disparities and is significantly influenced by the inflammatory status. This makes prediction of alloreactive T-cell repertoires a major challenge in HLA mismatched HSCT.
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Affiliation(s)
- Florence Bettens
- Transplantation Immunology Unit and National Reference Laboratory for Histocompatibility, Geneva University Hospitals, Geneva, Switzerland
| | - Zuleika Calderin Sollet
- Transplantation Immunology Unit and National Reference Laboratory for Histocompatibility, Geneva University Hospitals, Geneva, Switzerland
| | - Stéphane Buhler
- Transplantation Immunology Unit and National Reference Laboratory for Histocompatibility, Geneva University Hospitals, Geneva, Switzerland
| | - Jean Villard
- Transplantation Immunology Unit and National Reference Laboratory for Histocompatibility, Geneva University Hospitals, Geneva, Switzerland
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Balgansuren G, Regen L, Sprague M, Shelton N, Petersdorf E, Hansen JA. Identification of the rs9277534 HLA-DP expression marker by next generation sequencing for the selection of unrelated donors for hematopoietic cell transplantation. Hum Immunol 2019; 80:828-833. [PMID: 31176504 DOI: 10.1016/j.humimm.2019.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/10/2019] [Accepted: 05/23/2019] [Indexed: 11/18/2022]
Abstract
Mismatching of an unrelated donor against a high-expression HLA-DPB1 recipient allele is associated with a high risk of graft-versus-host disease and mortality. The Seattle Cancer Care Alliance (SCCA) and Fred Hutchinson Cancer Research Center transplant program employs an algorithm to match for HLA-A, B, C, DRB1, DQB1 and DPB1 alleles (12/12) and to avoid, whenever possible, donor mismatching against a recipient high-expression HLA-DPB1 allele. HLA-DPB1 expression is associated with the rs9277534 A/G polymorphism located in the 3'UTR of the HLA-DPB1 gene. Next generation sequencing of HLA-DPB1 using the Illumina TruSight HLA V2 Sequencing Panel and Conexio Assign software analyses provides information on rs9277534 variants without the need for any additional SNP testing. Here we present the molecular location of rs9277534 in NGS data and discuss the challenges to resolve HLA-DPB1 ambiguities.
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Affiliation(s)
- Gansuvd Balgansuren
- Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, WA, USA; University of Washington, Seattle, WA, USA.
| | - Lois Regen
- Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Maggie Sprague
- Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Nakita Shelton
- Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Effie Petersdorf
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA; University of Washington, Seattle, WA, USA
| | - John A Hansen
- Clinical Immunogenetics Laboratory, Seattle Cancer Care Alliance, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA, USA; University of Washington, Seattle, WA, USA
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Hurley CK, Ng J. Continue to focus clinical decision-making on the antigen recognition domain for the present. Hum Immunol 2019; 80:79-84. [DOI: 10.1016/j.humimm.2018.04.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/10/2018] [Accepted: 04/15/2018] [Indexed: 02/04/2023]
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HLA mismatches that are identical for the antigen recognition domain are less immunogenic. Bone Marrow Transplant 2018; 53:729-740. [DOI: 10.1038/s41409-018-0108-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 12/18/2017] [Accepted: 01/04/2018] [Indexed: 11/08/2022]
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6
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What compatibility in 2017 for the haematopoietic stem cell transplantation? Transfus Clin Biol 2017; 24:124-130. [PMID: 28709842 DOI: 10.1016/j.tracli.2017.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 06/02/2017] [Indexed: 12/25/2022]
Abstract
The diversification of potential donors to perform stem cell allografts now enables to propose a compatible graft cell source adapted to the different clinical situations. Transplants with a geno-identical sibling donor, otherwise with the most HLA-compatible unrelated donor, remain the first-line solutions. Alternative transplants allow to graft patients having no donors in international registries, owing to the rarity of their HLA typing. They are carried out with fairly incompatible grafts and are therefore limited by the existence in the recipient of preformed anti-HLA antibodies which predispose to their rejection. The simple prevention of acute Graft-versus-host disease in haplo-identical transplants, as well as the availability of donors, explain why they have very often replaced placental stem cell transplants. These latter remain useful for pediatric patients or in the absence of family donors.
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Tu B, Masaberg C, Hou L, Behm D, Brescia P, Cha N, Kariyawasam K, Lee JH, Nong T, Sells J, Tausch P, Yang R, Ng J, Hurley CK. Combining one-step Sanger sequencing with phasing probe hybridization for HLA class I typing yields rapid, G-group resolution predicting 99% of unique full length protein sequences. HLA 2017; 89:90-97. [PMID: 28102036 DOI: 10.1111/tan.12951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/09/2016] [Accepted: 11/25/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sanger-based DNA sequencing of exons 2+3 of HLA class I alleles from a heterozygote frequently results in two or more alternative genotypes. This study was undertaken to reduce the time and effort required to produce a single high resolution HLA genotype. MATERIALS AND METHODS Samples were typed in parallel by Sanger sequencing and oligonucleotide probe hybridization. This workflow, together with optimization of analysis software, was tested and refined during the typing of over 42,000 volunteers for an unrelated hematopoietic progenitor cell donor registry. Next generation DNA sequencing (NGS) was applied to over 1000 of these samples to identify the alleles present within the G group designations. RESULTS Single genotypes at G level resolution were obtained for over 95% of the loci without additional assays. The vast majority of alleles identified (>99%) were the primary allele giving the G groups their name. Only 0.7% of the alleles identified encoded protein variants that were not detected by a focus on the antigen recognition domain (ARD)-encoding exons. CONCLUSION Our combined method routinely provides biologically relevant typing resolution at the level of the ARD. It can be applied to both single samples or to large volume typing supporting either bone marrow or solid organ transplantation using technologies currently available in many HLA laboratories.
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Affiliation(s)
- Bin Tu
- Departments of Oncology and Pediatrics, Georgetown University, Washington, District of Columbia
| | - Carly Masaberg
- Departments of Oncology and Pediatrics, Georgetown University, Washington, District of Columbia
| | - Lihua Hou
- Departments of Oncology and Pediatrics, Georgetown University, Washington, District of Columbia
| | | | - Peter Brescia
- One Lambda Inc. (Thermo Fisher Scientific), Canoga Park, California
| | - Nuri Cha
- Departments of Oncology and Pediatrics, Georgetown University, Washington, District of Columbia
| | - Kanthi Kariyawasam
- Departments of Oncology and Pediatrics, Georgetown University, Washington, District of Columbia
| | - Jar How Lee
- One Lambda Inc. (Thermo Fisher Scientific), Canoga Park, California
| | - Thoa Nong
- One Lambda Inc. (Thermo Fisher Scientific), Canoga Park, California
| | | | - Paul Tausch
- One Lambda Inc. (Thermo Fisher Scientific), Canoga Park, California
| | - Ruyan Yang
- Departments of Oncology and Pediatrics, Georgetown University, Washington, District of Columbia
| | - Jennifer Ng
- Departments of Oncology and Pediatrics, Georgetown University, Washington, District of Columbia
| | - Carolyn Katovich Hurley
- Departments of Oncology and Pediatrics, Georgetown University, Washington, District of Columbia
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Hou L, Vierra-Green C, Lazaro A, Brady C, Haagenson M, Spellman S, Hurley CK. Limited HLA sequence variation outside of antigen recognition domain exons of 360 10 of 10 matched unrelated hematopoietic stem cell transplant donor-recipient pairs. HLA 2016; 89:39-46. [PMID: 27976839 DOI: 10.1111/tan.12942] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/24/2016] [Accepted: 11/17/2016] [Indexed: 12/27/2022]
Abstract
Traditional DNA-based typing focuses primarily on interrogating the exons of human leukocyte antigen (HLA) genes that form the antigen recognition domain (ARD). The relevance of mismatching donor and recipient for HLA variation outside the ARD on hematopoietic stem cell transplantation (HSCT) outcomes is unknown. This study was designed to evaluate the frequency of variation outside the ARD in 10 of 10 (HLA-A, -B, -C, -DRB1, -DQB1) matched unrelated donor transplant pairs (n = 360). Next-generation DNA sequencing was used to characterize both HLA exons and introns for HLA-A, -B, -C alleles; exons 2, 3 and the intervening intron for HLA-DRB1 and exons only for HLA-DQA1 and -DQB1. Over 97% of alleles at each locus were matched for their nucleotide sequence outside of the ARD exons. Of the 4320 allele comparisons overall, only 17 allele pairs were mismatched for non-ARD exons, 41 for noncoding regions and 9 for ARD exons. The observed variation between donor and recipient usually involved a single nucleotide difference (88% of mismatches); 88% of the non-ARD exon variants impacted the amino acid sequence. The impact of amino acid sequence variation caused by substitutions in exons outside ARD regions in D-R pairs will be difficult to assess in HSCT outcome studies because these mismatches do not occur very frequently.
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Affiliation(s)
- L Hou
- Department of Pediatrics, Georgetown University, Washington, DC, USA
| | - C Vierra-Green
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - A Lazaro
- Department of Pediatrics, Georgetown University, Washington, DC, USA
| | - C Brady
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - M Haagenson
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - S Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - C K Hurley
- Department of Pediatrics, Georgetown University, Washington, DC, USA.,Department of Oncology, Georgetown University, Washington, DC, USA
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Bettens F, Buhler S, Tiercy JM. Allorecognition of HLA-C Mismatches by CD8 + T Cells in Hematopoietic Stem Cell Transplantation Is a Complex Interplay between Mismatched Peptide-Binding Region Residues, HLA-C Expression, and HLA-DPB1 Disparities. Front Immunol 2016; 7:584. [PMID: 28018351 PMCID: PMC5151176 DOI: 10.3389/fimmu.2016.00584] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 11/25/2016] [Indexed: 11/13/2022] Open
Abstract
HLA-C locus mismatches (MMs) are the most frequent class I disparities in unrelated hematopoietic stem cell transplantation (HSCT) and have a detrimental impact on clinical outcome. Recently, a few retrospective clinical studies have reported some variability in the immunogenicity of HLA-C incompatibilities. To get better insight into presumably permissive HLA-C MMs, we have developed a one-way in vitro mixed lymphocyte reaction (MLR) assay allowing to quantify activated CD56-CD137+CD8+ lymphocytes in HLA-C incompatible combinations. T cell-mediated alloresponses were correlated with genetic markers such as HLA-C mRNA expression and the number of amino acid (aa) MMs in the α1/α2 domains (peptide-binding region). Because of the high rate of HLA-DPB1 incompatibilities in HLA-A-, B-, C-, DRB1-, and DQB1-matched unrelated HSCT patient/donor pairs, the impact of HLA-DPB1 mismatching, a potential bystander of CD4+ T cell activation, was also considered. Heterogeneous alloresponses were measured in 63 HLA-C-mismatched pairs with a positive assay in 52% of the combinations (2.3-18.6% activated CTLs), representing 24 different HLA-A~B~DRB1~DQB1 haplotypes. There was no correlation between measured alloresponses and mRNA expression of the mismatched HLA-C alleles. The HLA-C*03:03/03:04 MM did not induce any positive alloresponse in five MLRs. We also identified HLA-C*02:02 and HLA-C*06:02 as mismatched alleles with lower immunogenicity, and HLA-C*14:02 as a more immunogenic MM. A difference of at least 10 aa residues known to impact peptide/T cell receptor (TCR) binding and a bystander HLA-DPB1 incompatibility had a significant impact on CTL alloreactivity (p = 0.021). The same HLA-C MM, when recognized by two different responders with the same HLA haplotypes, was recognized differently, emphasizing the role of the T-cell repertoire of responding cells. In conclusion, mismatched HLA-C alleles differing by 10 or more aas in the peptide/TCR-binding region, when occurring together with HLA-DPB1 incompatibilities, should be considered as high-risk MMs in unrelated HSCT.
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Affiliation(s)
- Florence Bettens
- National Reference Laboratory for Histocompatibility, Department of Genetic and Laboratory Medicine, University Hospitals Geneva , Geneva , Switzerland
| | - Stéphane Buhler
- National Reference Laboratory for Histocompatibility, Department of Genetic and Laboratory Medicine, University Hospitals Geneva , Geneva , Switzerland
| | - Jean-Marie Tiercy
- National Reference Laboratory for Histocompatibility, Department of Genetic and Laboratory Medicine, University Hospitals Geneva , Geneva , Switzerland
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Polymorphisme des gènes HLA et KIR et l’impact sur le devenir de la greffe et le choix du donneur non apparenté de cellules souche hématopoïétiques : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC). Bull Cancer 2016; 103:S243-S247. [DOI: 10.1016/j.bulcan.2016.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 09/01/2016] [Indexed: 02/02/2023]
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HapLogic: A Predictive Human Leukocyte Antigen–Matching Algorithm to Enhance Rapid Identification of the Optimal Unrelated Hematopoietic Stem Cell Sources for Transplantation. Biol Blood Marrow Transplant 2016; 22:2038-2046. [DOI: 10.1016/j.bbmt.2016.07.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 07/29/2016] [Indexed: 01/23/2023]
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12
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Grubic Z, Stingl Jankovic K, Maskalan M, Serventi-Seiwerth R, Mikulic M, Nemet D, Burek Kamenaric M, Labar B, Zunec R. The effect of HLA allele and haplotype polymorphisms on donor matching in hematopoietic stem cell transplantation - Croatian experience. Hum Immunol 2016; 77:1120-1127. [PMID: 27756586 DOI: 10.1016/j.humimm.2016.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/10/2016] [Accepted: 10/14/2016] [Indexed: 11/29/2022]
Abstract
The knowledge of HLA characteristics of a patient's population helps to predict the probability of finding a MUD. The study included 170 transplanted patients for whom a search for a MUD in BMDW was performed and a sample of 4000 volunteer unrelated donors from the Croatian Bone Marrow Donor Registry (CBMDR). Patients and their MUDs were typed for HLA-A, -B, -C, -DRB1, and -DQB1 loci using PCR-SSO and PCR-SSP methods while donors were typed for HLA-A, -B, -C, and -DRB1 loci using the PCR-SSO method. A comparison of allele frequencies at tested HLA loci between patients and donors from CBMDR did not reveal significant differences. The majority of patients (117, 68.8%) had a 10/10 MUD, 45 (26.5%) patients had a 9/10 MUD and eight (4.7%) patients had an 8/10 MUD. The highest number of mismatches (MM) was present at HLA-DRB1 (19; 31.1%). The presence of DRB1*11 and DRB1*04 allelic groups among patients caused allelic MMs at HLA-DRB1 in most cases. The presence of an infrequent HLA-B∼C haplotype resulted in the HLA-C MM at antigen level in the majority of cases. The present study clarified HLA factors that cause difficulties in searching for a 10/10 MUD for Croatian patients.
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Affiliation(s)
- Zorana Grubic
- Tissue Typing Centre, Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Katarina Stingl Jankovic
- Tissue Typing Centre, Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Marija Maskalan
- Tissue Typing Centre, Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ranka Serventi-Seiwerth
- Department of Haematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mirta Mikulic
- Croatian Bone Marrow Donor Registry, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Damir Nemet
- Department of Haematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Marija Burek Kamenaric
- Tissue Typing Centre, Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Boris Labar
- Department of Haematology, Internal Clinic, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Renata Zunec
- Tissue Typing Centre, Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
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Tiercy JM. How to select the best available related or unrelated donor of hematopoietic stem cells? Haematologica 2016; 101:680-7. [PMID: 27252513 DOI: 10.3324/haematol.2015.141119] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/09/2016] [Indexed: 11/09/2022] Open
Abstract
Recognition of HLA incompatibilities by the immune system represents a major barrier to allogeneic hematopoietic stem cell transplantation. HLA genotypically identical sibling donors are, therefore, the gold standard for transplantation purposes, but only 30% patients have such a donor. For the remaining 70% patients alternative sources of stem cells are a matched unrelated adult volunteer donor, a haploidentical donor or a cord blood unit. The definition of 'HLA matching' depends on the level of resolution and on which loci are tested. The development of HLA molecular typing technologies and the availability of more than 27 million donors in the international database has greatly facilitated unrelated donor searches. The gold standard is high resolution typing at the HLA-A, -B, -C, -DRB1, and -DQB1 loci (10/10 match). Single disparities for HLA-A, -B, - C, or -DRB1 are associated with increased risk of post-transplant complications, but less so in patients with advanced disease, and in those undergoing T-cell-depleted allografting. HLA-DQB1 mismatches seem to be better tolerated and some HLA-C, -DRB1 and -DPB1 disparities are potentially less immunogenic. HLA typing by next-generation sequencing methods is likely to change matching algorithms by providing full sequence information on all HLA loci in a single step. In most European populations a 10/10 matched donor can be found for at least 50% of patients and an additional 20-30% patients may have a 9/10 matched donor. Genetic factors that help in identifying donors with less immunogenic mismatches are discussed. Haploidentical donors are increasingly used as an alternative source of stem cells for those patients lacking a matched unrelated donor.
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Affiliation(s)
- Jean-Marie Tiercy
- National Reference Laboratory for Histocompatibility, Department of Genetic and Laboratory Medicine, University Hospitals Geneva, Switzerland
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14
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Vidan-Jeras B, Buhler S, Dubois V, Grubic Z, Ivanova M, Jaatinen T, Ligeiro D, Lokki ML, Papasteriades C, Poli F, Spyropoulou-Vlachou M, Tordai A, Viken M, Wenda S, Nunes J, Sanchez-Mazas A, Tiercy JM. Resolution ofHLA-B*44:02:01G, -DRB1*14:01:01Gand -DQB1*03:01:01Greveals a high allelic variability among 12 European populations. ACTA ACUST UNITED AC 2014; 84:459-64. [DOI: 10.1111/tan.12422] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 07/14/2014] [Accepted: 07/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- B. Vidan-Jeras
- Tissue Typing Center; Blood Transfusion Center of Slovenia; Ljubljana Slovenia
| | - S. Buhler
- Laboratory of Anthropology, Genetics and Peopling History, Department of Genetics and Evolution - Anthropology Unit and Institute of Genetics and Genomics in Geneva (IGE3); University of Geneva; Geneva Switzerland
| | - V. Dubois
- Etablissement Français du Sang (EFS) Rhône-Alpes; Laboratoire HLA; Lyon France
| | - Z. Grubic
- Tissue Typing Centre; University Hospital Centre Zagreb; Zagreb Croatia
| | - M. Ivanova
- Department of Clinical Immunology; University Hospital Alexandrovska; Sofia Bulgaria
| | - T. Jaatinen
- Finnish Red Cross Blood Service; Clinical Laboratory; Helsinki Finland
| | - D. Ligeiro
- Centro de Histocompatibilidad do Sul; Instituto Português de Sangue e Transplantaçâo; Lisbon Portugal
| | - M.-L. Lokki
- Transplantation Laboratory, Haartman Institute; University of Helsinki; Helsinki Finland
| | - C. Papasteriades
- Department of Immunology and Histocompatibility; Evangelismos Hospital; Athens Greece
| | - F. Poli
- Organ and Tissue Transplantation Immunology, Regenerative Medicine Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milan Italy
| | - M. Spyropoulou-Vlachou
- Immunology Department - Tissue Typing Laboratory; General University Hospital of Athens Alexandra; Athens Greece
| | - A. Tordai
- Hungarian National Blood Transfusion Center; Transplantation Immunogenetics Laboratory; Budapest Hungary
| | - M.K. Viken
- Department of Immunology; Oslo University Hospital and University of Oslo; Oslo Norway
| | - S. Wenda
- Department for Blood Group Serology; Medical University Vienna; Wien Austria
| | - J.M. Nunes
- Laboratory of Anthropology, Genetics and Peopling History, Department of Genetics and Evolution - Anthropology Unit and Institute of Genetics and Genomics in Geneva (IGE3); University of Geneva; Geneva Switzerland
| | - A. Sanchez-Mazas
- Laboratory of Anthropology, Genetics and Peopling History, Department of Genetics and Evolution - Anthropology Unit and Institute of Genetics and Genomics in Geneva (IGE3); University of Geneva; Geneva Switzerland
| | - J.-M. Tiercy
- National Reference Laboratory for Histocompatibility; University Hospital Geneva; Geneva Switzerland
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15
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Soluble HLA technology as a strategy to evaluate the impact of HLA mismatches. J Immunol Res 2014; 2014:246171. [PMID: 25254222 PMCID: PMC4165401 DOI: 10.1155/2014/246171] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 07/15/2014] [Accepted: 08/05/2014] [Indexed: 11/17/2022] Open
Abstract
HLA class I incompatibilities still remain one of the main barriers for unrelated bone marrow transplantation (BMT); hence the molecular understanding of how to mismatch patients and donors and still have successful clinical outcomes will guide towards the future of unrelated BMT. One way to estimate the magnitude of polymorphisms within the PBR is to determine which peptides can be selected by individual HLA alleles and subsequently presented for recognition by T cells. The features (structure, length, and sequence) of different peptides each confer an individual pHLA landscape and thus directly shape the individual immune response. The elution and sequencing of peptides by mass spectrometric analysis enable determining the bona fide repertoire of presented peptides for a given allele. This is an effective and simple way to compare the functions of allelic variants and make a first assessment of their degree of permissivity. We describe the methodology used for peptide sequencing and the limitations of peptide prediction tools compared to experimental methods. We highlight the altered peptide features that are observed between allelic variants and the need to discover the altered peptide repertoire in situations of "artificial" graft versus host disease (GvHD) that occur in HLA-specific hypersensitive immune responses to drugs.
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Tiercy JM. HLA-C Incompatibilities in Allogeneic Unrelated Hematopoietic Stem Cell Transplantation. Front Immunol 2014; 5:216. [PMID: 24904572 PMCID: PMC4032933 DOI: 10.3389/fimmu.2014.00216] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/29/2014] [Indexed: 11/14/2022] Open
Abstract
An increasingly larger fraction of patients with hematological diseases are treated by hematopoietic stem cells transplantation (HSCT) from HLA matched unrelated donors. Polymorphisms of HLA genes represent a major barrier to HSCT because HLA-A, -B, -C and DRB1 incompatibilities confer a higher risk of acute graft-versus-host disease (aGVHD) and mortality. Although >22 million volunteer HLA-typed donors are available worldwide, still a significant number of patients do not find a highly matched HSC donor. Because of the large haplotypic diversity in HLA-B–C associations, incompatibilities occur most frequently at HLA-C, so that unrelated donors with a single HLA-C mismatch often represent the only possible choice. The ratio of HLA-C-mismatched HSCT over the total number of transplants varies from 15 to 30%, as determined in 12 multicenter studies. Six multicenter studies involving >1800 patients have reported a 21–43% increase in mortality risk. By using in vitro cellular assays, a large heterogeneity in T-cell allorecognition has been observed. Yet the permissiveness of individual HLA-C mismatches remains poorly defined. It could be linked to the position and nature of the mismatched residues on HLA-C molecules, but also to variability in the expression levels of the mismatched alleles. The permissive C*03:03–03:04 mismatch is characterized by full compatibility at residues 9, 97, 99, 116, 152, 156, and 163 reported to be key positions influencing T-cell allorecognition. With a single difference among these seven key residues the C*07:01–07:02 mismatch might also be considered by analogy as permissive. High variability of HLA-C expression as determined by quantitative RT-PCR has been observed within individual allotypes and shows some correlation with A–B–C–DRB1 haplotypes. Thus in addition to the position of mismatched amino acid residues, expression level of patient’s mismatched HLA-C allotype might influence T-cell allorecognition, with patients low expression-C alleles representing possible permissive mismatches.
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Affiliation(s)
- Jean-Marie Tiercy
- Transplantation Immunology Unit, National Reference Laboratory for Histocompatibility, Department of Genetics and Laboratory Medicine, University Hospital of Geneva, University of Geneva , Geneva , Switzerland
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Becker PSA, Seifried E, Seidl C. The novel alleles HLA-B*44:101 and HLA-B*57:48 of Caucasian origin are characterized by amino acid substitutions in the alpha 2 domain. ACTA ACUST UNITED AC 2014; 83:295-6. [PMID: 24456416 DOI: 10.1111/tan.12294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/27/2013] [Accepted: 12/22/2013] [Indexed: 11/29/2022]
Abstract
HLA-B*44:101 and HLA-B*57:48 are characterized by amino acid substitutions in the alpha 2 domain.
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Affiliation(s)
- P S A Becker
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Donor Service Baden-Wuerttemberg - Hessen, Frankfurt, Germany
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