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Mehta RS, Petersdorf EW, Spellman SR, Lee SJ. Combined effect of unrelated donor age and HLA peptide-binding motif match status on HCT outcomes. Blood Adv 2024; 8:2235-2242. [PMID: 38467032 PMCID: PMC11061210 DOI: 10.1182/bloodadvances.2024012669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/20/2024] [Accepted: 03/03/2024] [Indexed: 03/13/2024] Open
Abstract
ABSTRACT An HLA-mismatched unrelated donor who is class I peptide-binding motif (PBM)-matched is preferred over a PBM-mismatched donor. We hypothesized that using a younger donor (aged ≤35 years vs >35 years) could compensate for the inferior overall survival (OS) associated with PBM mismatches. We compared 6 groups: HLA-matched/younger donor (n = 10 531), HLA-matched/older donor (n = 3572), PBM-matched/younger donor (n = 357), PBM-matched/older donor (n = 257), PBM-mismatched/younger donor (n = 616), and PBM-mismatched/older donor (n = 339) in patients undergoing transplantation with conventional graft-versus-host disease prophylaxis. In multivariate analysis, HLA-matched/younger donors were associated with superior OS relative to any other group. Pairwise comparisons showed that donor age significantly impacted OS in both HLA-matched and HLA-mismatched groups. Moreover, younger donors appeared to negate the detrimental effect of PBM mismatching: the PBM-matched/younger donor group had similar OS as the HLA-matched/older donor group and the PBM-mismatched/younger donor group had similar OS as the PBM-matched/older donor group. Our study suggests that older unrelated donor age and PBM mismatching confer similarly adverse effects on OS and the impacts are additive, a finding which may widen the "acceptable" donor pool. The best OS is observed with HLA-matched/younger donors and the worst with PBM-mismatched/older donors. These findings should be validated with other data sets and with posttransplantation cyclophosphamide-based prophylaxis.
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Affiliation(s)
- Rohtesh S. Mehta
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA
| | - Effie W. Petersdorf
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA
- Division of Translational Science and Therapeutics, Fred Hutchinson Cancer Center, Seattle, WA
| | - Stephen R. Spellman
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program, Minneapolis, MN
| | - Stephanie J. Lee
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program, Minneapolis, MN
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2
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Petersdorf EW, McKallor C, Malkki M, He M, Spellman SR, Gooley T, Stevenson P. HLA Haplotypes and Relapse After Hematopoietic Cell Transplantation. J Clin Oncol 2024; 42:886-897. [PMID: 38051980 PMCID: PMC10927336 DOI: 10.1200/jco.23.01264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/25/2023] [Accepted: 10/06/2023] [Indexed: 12/07/2023] Open
Abstract
PURPOSE Recurrence of blood malignancy is the major cause of hematopoietic cell transplant failure. HLA class II molecules play a fundamental role in antitumor responses but the role of class II haplotypes is not known. METHODS HLA-DR, -DQ, -DM, and -DO allele variation was determined in 1,629 related haploidentical transplants to study the clinical significance of individual molecules and haplotypes. RESULTS Outcome correlated with patient and donor variation for HLA-DRβ residue 86 (Gly/Val), HLA-DQ (G1/G2) heterodimers, and donor HLA-DM (DM11,11/nonDM11,11) molecules, and depended on patient-donor mismatching. Risks of relapse were lower for DRβ-86 GlyGly patients when the donor was GlyVal (hazard ratio [HR], 0.46 [95% CI, 0.30 to 0.68]; P < .001); GlyVal patients benefited from HLA-DRB1-matched donors, whereas no donor was superior to another for ValVal patients. G1G2 patients with G1G2-mismatched donors had lower relapse. Transplantation from donors with DMα residue 184 ArgHis was associated with higher risk of relapse (HR, 1.60 [95% CI, 1.09 to 2.36]; P = .02) relative to ArgArg. Relapse and mortality risks differed across HLA-DR-DQ-DM haplotypes. CONCLUSION HLA class II haplotypes may be functional constituents of the transplantation barrier, and their consideration in patients and donors may improve the success of transplantation.
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Affiliation(s)
- Effie W. Petersdorf
- Division of Translational Science and Therapeutics, Fred Hutchinson Cancer Center, Seattle, WA
- University of Washington School of Medicine, Seattle, WA
| | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
| | - Mari Malkki
- Division of Translational Science and Therapeutics, Fred Hutchinson Cancer Center, Seattle, WA
| | - Meilun He
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Stephen R. Spellman
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Theodore Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
| | - Philip Stevenson
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
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3
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Sajulga R, Bolon YT, Maiers MJ, Petersdorf EW. Assessment of HLA-DPB1 genetic variation using an HLA-DP tool and its implications in clinical transplantation. Blood Adv 2023; 7:4809-4821. [PMID: 37126658 PMCID: PMC10469530 DOI: 10.1182/bloodadvances.2022009554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/06/2023] [Accepted: 04/23/2023] [Indexed: 05/03/2023] Open
Abstract
HLA-DP is a classic transplantation antigen that mediates alloreactivity through T-cell epitope (TCE) diversity and expression levels. A current challenge is to integrate these functional features into the prospective selection of unrelated donor candidates for transplantation. Genetically, HLA-DPB1 exon 2 defines the permissive and nonpermissive TCE groups, and exons 2 and 3 (in linkage with rs9277534) indicate low- and high-expression allotypes. In this study, we analyzed 356 272 exon 2-exon 3-phased sequences from individuals across 5 self-identified race and ethnicity categories: White, Hispanic, Asian or Pacific Islander, Black or African American, and American Indian or Alaskan Native. This sequence data set revealed the complex relationship between TCE and expression models and the importance of exon 3 sequence data. We also studied archived donor search lists for 2545 patients who underwent transplantation from an HLA-11/12 unrelated donor mismatched for a single HLA-DPB1 allele. Depending on the order in which the TCE and expression criteria were considered, some patients had different TCE- and expression-favorable donors. In addition, this data set revealed that many expression-favorable alternatives existed in the search lists. To improve the selection of candidate donors, we provide, disseminate, and automate our findings through our multifaceted tool called Expression of HLA-DP Assessment Tool, consisting of a public web application, Python package, and analysis pipeline.
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Affiliation(s)
- Ray Sajulga
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Yung-Tsi Bolon
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Martin J. Maiers
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Effie W. Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
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4
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Petersdorf EW, McKallor C, Malkki M, He M, Spellman SR, Hsu KC, Strong RK, Gooley T, Stevenson P. Role of NKG2D ligands and receptor in haploidentical related donor hematopoietic cell transplantation. Blood Adv 2023; 7:2888-2896. [PMID: 36763517 PMCID: PMC10300293 DOI: 10.1182/bloodadvances.2022008922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/10/2022] [Accepted: 12/06/2022] [Indexed: 02/11/2023] Open
Abstract
The recurrence of malignancy after hematopoietic cell transplantation (HCT) is the primary cause of transplantation failure. The NKG2D axis is a powerful pathway for antitumor responses, but its role in the control of malignancy after HCT is not well-defined. We tested the hypothesis that gene variation of the NKG2D receptor and its ligands MICA and MICB affect relapse and survival in 1629 patients who received a haploidentical HCT for the treatment of a malignant blood disorder. Patients and donors were characterized for MICA residue 129, the exon 5 short tandem repeat (STR), and MICB residues 52, 57, 98, and 189. Donors were additionally defined for the presence of NKG2D residue 72. Mortality was higher in patients with MICB-52Asn relative to those with 52Asp (hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.24-2.71; P = .002) and lower in those with MICA-STR mismatch than in those with STR match (HR, 0.66; 95% CI, 0.54-0.79; P = .00002). Relapse was lower with NKG2D-72Thr donors than with 72Ala donors (relapse HR, 0.57; 95% CI, 0.35-0.91; P = .02). The protective effects of patient MICB-52Asp with donor MICA-STR mismatch and NKG2D-72Thr were enhanced when all 3 features were present. The NKG2D ligand/receptor pathway is a transplantation determinant. The immunobiology of relapse is defined by the concerted effects of MICA, MICB, and NKG2D germ line variation. Consideration of NKG2D ligand/receptor pairings may improve survival for future patients.
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Affiliation(s)
- Effie W. Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
| | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
| | - Meilun He
- National Marrow Donor Program/BeTheMatch, Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Stephen R. Spellman
- National Marrow Donor Program/BeTheMatch, Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Katharine C. Hsu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Roland K. Strong
- Division of Basic Sciences, Fred Hutchinson Cancer Center, Seattle, WA
| | - Ted Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
| | - Phil Stevenson
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
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5
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Roberts L, Milano F, Gooley TA, Mielcarek M, Linenberger M, Petersdorf EW, Sandmaier PBM, Connelly-Smith L. Fresh Versus Cryopreserved Allograft Outcomes in Peripheral Blood Stem Cell Transplantations. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00375-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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6
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Petersdorf EW, Bengtsson M, Horowitz M, McKallor C, Spellman SR, Spierings E, Gooley TA, Stevenson P. HLA-DQ heterodimers in hematopoietic cell transplantation. Blood 2022; 139:3009-3017. [PMID: 35271697 PMCID: PMC9121842 DOI: 10.1182/blood.2022015860] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 02/24/2022] [Indexed: 11/20/2022] Open
Abstract
HLA-DQ heterodimers increase the susceptibility to autoimmune diseases, but their role in hematopoietic cell transplantation is unknown. We tested the hypothesis that outcome after HLA-matched and HLA-DQ-mismatched hematopoietic cell transplantation is influenced by HLA-DQ heterodimers. Heterodimers were defined in 5164 HLA-matched and 520 HLA-DQ-mismatched patients and their transplant donors according to well-established crystallographic criteria. Group 1 (G1) heterodimers are any DQA1*02/03/04/05/06α paired with any DQB1*02/03/04β. Group 2 (G2) heterodimers are DQA1*01α paired with any DQB1*05/06β. Multivariable models identified significantly higher relapse risk in G1G2 and G2G2 compared with G1G1 HLA-matched patients with malignant disease; risk increased with an increasing number of G2 molecules. In HLA-DQ-mismatched transplantation for malignant diseases, matching or mismatching for G2 increased relapse risk. G2 lowered disease-free survival after both HLA-matched and HLA-DQ-mismatched transplantation. A paradigm based on HLA-DQ heterodimers provides a functional definition of the hematopoietic cell transplantation barrier and a means to lower risks for future patients.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | - Mats Bengtsson
- Department of Immunology, Genetics, and Pathology, University of Uppsala, Uppsala, Sweden
| | - Mary Horowitz
- Center for International Blood and Marrow Transplant Research, Milwaukee, WI
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Eric Spierings
- Matchis Foundation, Leiden, The Netherlands; and
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ted A Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Phil Stevenson
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
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7
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Ruggeri A, de Wreede LC, Müller CR, Crivello P, Bonneville EF, Petersdorf EW, Socié G, Dubois V, Niittyvuopio R, Peräsaari J, Yakoub-Agha I, Cornelissen JJ, Wieten L, Gedde-Dahl T, Forcade E, Crawley CR, Marsh SG, Gandemer V, Tholouli E, Bulabois CE, Huynh A, Choi G, Deconinck E, Itäla-Remes M, Lenhoff S, Bengtsson M, Johansson JE, van Gorkom G, Hoogenboom JD, Vago L, Rocha V, Bonini C, Chabannon C, Fleischhauer K. Integrating biological HLA-DPB1 mismatch models to predict survival after unrelated hematopoietic cell transplantation. Haematologica 2022; 108:645-652. [PMID: 35546480 PMCID: PMC9890035 DOI: 10.3324/haematol.2021.280055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Indexed: 02/03/2023] Open
Affiliation(s)
- Annalisa Ruggeri
- San Raffaele Scientific Institute, Hematology and Bone Marrow Transplantation Unit, Milan, Italy,Cellular Therapy and Immunobiology Working Party of the EBMT, Leiden, the Netherlands
| | | | | | - Pietro Crivello
- Institute for Experimental Cellular Therapy, University Hospital Essen, Essen, Germany
| | | | | | | | | | | | - Juha Peräsaari
- Clinical Laboratory Services, Histocompatibility Testing, Finnish Red Cross Blood Service, Helsinki, Finland
| | | | | | - Lotte Wieten
- Transplantation Immunology, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | | | | | - Steven G.E. Marsh
- Anthony Nolan Research Institute and UCL Cancer Institute, Royal Free Campus, London, UK
| | | | | | | | - Anne Huynh
- CHU - Institut Universitaire du Cancer Toulouse, Toulouse, France
| | - Goda Choi
- University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | | | | | | | - Mats Bengtsson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | | | | | - Luca Vago
- San Raffaele Scientific Institute, Hematology and Bone Marrow Transplantation Unit, Milan, Italy,Cellular Therapy and Immunobiology Working Party of the EBMT, Leiden, the Netherlands
| | - Vanderson Rocha
- Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Onco-Immuno-Hematology (LIM-31) of the Service of Hematology and Cell Therapy, Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, SP, Brazil
| | - Chiara Bonini
- San Raffaele Scientific Institute, Hematology and Bone Marrow Transplantation Unit, Milan, Italy,Cellular Therapy and Immunobiology Working Party of the EBMT, Leiden, the Netherlands
| | - Christian Chabannon
- Cellular Therapy and Immunobiology Working Party of the EBMT, Leiden, the Netherlands,Institut PaoliCalmettes, Centre de Lutte Contre le Cancer, Centre d'Investigations Cliniques en Biothérapie, Université d'Aix-Marseille, Inserm CBT 1409, Marseille, France
| | - Katharina Fleischhauer
- Cellular Therapy and Immunobiology Working Party of the EBMT, Leiden, The Netherlands; Institute for Experimental Cellular Therapy, University Hospital Essen, Essen.
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8
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Morishima Y, Morishima S, Stevenson P, Kodera Y, Horowitz M, McKallor C, Malkki M, Spellman SR, Gooley T, Petersdorf EW. Race and Survival in Unrelated Hematopoietic Cell Transplantation. Transplant Cell Ther 2022; 28:357.e1-357.e6. [PMID: 35405366 DOI: 10.1016/j.jtct.2022.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/14/2022] [Accepted: 03/30/2022] [Indexed: 11/18/2022]
Abstract
Survival after hematopoietic cell transplantation depends on race/ethnicity and histocompatibility (HLA) between the patient and transplant donor. HLA sequence variation is a genetic construct of continental populations, but its role in accounting for racial disparities of transplant outcome is unknown. To determine disparities in transplant survivorship among patients of diverse race while accounting for patient and donor HLA variation. A total of 26,945 self-described Japanese, U.S. Asian, White, Hispanic, and Black patients received an unrelated donor transplant for the treatment of a life-threatening blood disorder. The risk of mortality with and without adjustment for known HLA risk factors (number and location of donor mismatches; patient HLA-B leader genotype and HLA-DRβ peptide-binding motif) was studied using multivariable models. Survival after HLA-matched transplantation for patients with optimal leader and peptide-binding features was estimated for each race, as was the improvement in survival over calendar-year time by considering year of transplantation as a continuous linear variable. The number, location, and nature of donor HLA mismatches and the frequency of patient HLA-B and HLA-DRB1 sequence motifs differed by race. Japanese patients had superior survival compared to other races without consideration of HLA. After HLA adjustment, three mortality risk strata were identified: Japanese and U.S. Asian (low-risk); White and Hispanic (intermediate-risk), and Black patients (high-risk). Survival for patients with optimal donor and HLA characteristics was superior for Japanese, intermediate for U.S. Asian, White, and Hispanic, and lowest for Black patients. Five-year increments of transplant year were associated with greater decreases in mortality hazards for Black and Hispanic patients than for Japanese, U.S. Asian and White patients. Transplant survivorship disparities are influenced by HLA as a genetic construct of race. A more complete understanding of the factors that influence transplant outcomes provides opportunities to narrow disparities for future patients.
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Affiliation(s)
- Yasuo Morishima
- Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University, Nagakute Japan; Department of Hematology and Oncology, Nakagami Hospital, Okinawa, Japan.
| | - Satoko Morishima
- Division of Endocrinology, Diabetes and Metabolism, Hematology and Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Phil Stevenson
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Yoshihisa Kodera
- Japan Marrow Donor Program, Tokyo, Japan; Center for Hematopoietic Stem Cell Transplantation, Aichi Medical University Hospital, Nagakute, Japan
| | - Mary Horowitz
- Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin; Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | - Ted Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medicine, University of Washington, Seattle, Washington.
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9
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Fuchs EJ, McCurdy SR, Solomon SR, Wang T, Herr MR, Modi D, Grunwald MR, Nishihori T, Kuxhausen M, Fingerson S, McKallor C, Bashey A, Kasamon YL, Bolon YT, Saad A, McGuirk J, Paczesny S, Gadalla SM, Marsh SGE, Shaw BE, Spellman SR, Lee SJ, Petersdorf EW. HLA informs risk predictions after haploidentical stem cell transplantation with posttransplantation cyclophosphamide. Blood 2022; 139:1452-1468. [PMID: 34724567 PMCID: PMC8914182 DOI: 10.1182/blood.2021013443] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
Hematopoietic cell transplantation from HLA-haploidentical related donors is increasingly used to treat hematologic cancers; however, characteristics of the optimal haploidentical donor have not been established. We studied the role of donor HLA mismatching in graft-versus-host disease (GVHD), disease recurrence, and survival after haploidentical donor transplantation with posttransplantation cyclophosphamide (PTCy) for 1434 acute leukemia or myelodysplastic syndrome patients reported to the Center for International Blood and Marrow Transplant Research. The impact of mismatching in the graft-versus-host vector for HLA-A, -B, -C, -DRB1, and -DQB1 alleles, the HLA-B leader, and HLA-DPB1 T-cell epitope (TCE) were studied using multivariable regression methods. Outcome was associated with HLA (mis)matches at individual loci rather than the total number of HLA mismatches. HLA-DRB1 mismatches were associated with lower risk of disease recurrence. HLA-DRB1 mismatching with HLA-DQB1 matching correlated with improved disease-free survival. HLA-B leader matching and HLA-DPB1 TCE-nonpermissive mismatching were each associated with improved overall survival. HLA-C matching lowered chronic GVHD risk, and the level of HLA-C expression correlated with transplant-related mortality. Matching status at the HLA-B leader and HLA-DRB1, -DQB1, and -DPB1 predicted disease-free survival, as did patient and donor cytomegalovirus serostatus, patient age, and comorbidity index. A web-based tool was developed to facilitate selection of the best haploidentical-related donor by calculating disease-free survival based on these characteristics. In conclusion, HLA factors influence the success of haploidentical transplantation with PTCy. HLA-DRB1 and -DPB1 mismatching and HLA-C, -B leader, and -DQB1 matching are favorable. Consideration of HLA factors may help to optimize the selection of haploidentical related donors.
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Affiliation(s)
- Ephraim J Fuchs
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD
| | | | - Scott R Solomon
- Northside Hospital Cancer Institute, Blood and Marrow Transplant Program, Atlanta, GA
| | - Tao Wang
- Department of Medicine, Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | | | | | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL
| | - Michelle Kuxhausen
- CIBMTR, National Marrow Donor Program/Be The Match Foundation, Minneapolis, MN
| | - Stephanie Fingerson
- CIBMTR, National Marrow Donor Program/Be The Match Foundation, Minneapolis, MN
| | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Asad Bashey
- Northside Hospital Cancer Institute, Blood and Marrow Transplant Program, Atlanta, GA
| | - Yvette L Kasamon
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD
| | - Yung-Tsi Bolon
- CIBMTR, National Marrow Donor Program/Be The Match Foundation, Minneapolis, MN
| | - Ayman Saad
- Division of Hematology, Ohio State University, Columbus, OH
| | - Joseph McGuirk
- Division of Hematologic Malignancies and Cellular Therapeutics, The University of Kansas Cancer Center, Kansas City, KS
| | - Sophie Paczesny
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, Clinical Genetics Branch, Rockville, MD
| | - Steven G E Marsh
- Anthony Nolan Research Institute-University College London Cancer Institute, Royal Free Campus, London, United Kingdom; and
| | - Bronwen E Shaw
- Department of Medicine, Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI
| | - Stephen R Spellman
- CIBMTR, National Marrow Donor Program/Be The Match Foundation, Minneapolis, MN
| | - Stephanie J Lee
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, CIBMTR, Medical College of Wisconsin, Milwaukee, WI
| | - Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
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10
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El-Jawahri AR, Meyer CL, Mau LW, Mattila D, Burns L, Ullrich C, Murthy H, Wood W, Petersdorf EW, LeBlanc TW. What Do Patients Think about Palliative Care? A National Survey of Hematopoietic Stem Cell Transplant Recipients. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00673-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Sajulga Jr. R, Bolon YT, Maiers M, Petersdorf EW. A Tool to Assess Functional HLA-DPB1 Variation in Transplantation. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00623-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Petersdorf EW, Gooley T, Volt F, Kenzey C, Madrigal A, McKallor C, Querol S, Rafii H, Rocha V, Tamouza R, Chabannon C, Ruggeri A, Gluckman E. Use of the HLA-B leader to optimize cord-blood transplantation. Haematologica 2020; 106:3107-3114. [PMID: 33121238 PMCID: PMC8634170 DOI: 10.3324/haematol.2020.264424] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Indexed: 11/09/2022] Open
Abstract
Cord blood transplantation (CBT) can cure life-threatening blood disorders. The HLA-B leader affects the success of unrelated donor transplantation but its role in CBT is unknown. We tested the hypothesis that the HLA-B leader influences CBT outcomes in unrelated single-unit cord blood transplants performed by Eurocord/European Blood and Marrow Transplant (EBMT) centers between 1990 and 2018 with data reported to Eurocord. Among 4,822 transplants, 2,178 had one HLA-B mismatch of which 1,013 were HLAA and HLA-A and -DRB1 matched. The leader (methionine [M] or threonine [T]) was determined for each HLA-B allele in patients and units to define the genotype. Among single HLA-B-mismatched transplants, the patient/unit mismatched alleles were defined as leader-matched if they encoded the same leader, or leader-mismatched if they encoded different leaders; the leader encoded by the matched (shared) allele was determined. The risks of graft-versus-host disease, relapse, non-relapse mortality and overall mortality were estimated for various leader-defined groups using multi-variable regression models. Among the 1,013 HLA-A and -DRB1-matched transplants with one HLA-B mismatch, increasing numbers of cord blood unit M-leader alleles was associated with increased risk of relapse (hazard ratio [HR] for each increase in one Mleader allele 1.30, 95% Confidence Interval [CI]: 1.05-1.60, P=0.02). Furthermore, leader mismatching together with an M-leader of the shared HLA-B allele lowered non-relapse mortality (HR 0.44, 95% CI: 0.23-0.81; P=0.009) relative to leader matching and a shared T-leader allele. The HLA-B leader may inform relapse and non-relapse mortality risk after CBT. Future patients might benefit from the appropriate selection of units that consider the leader.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, Seattle, WA 98109, USA; Department of Medicine, University of Washington, Seattle, WA 98105.
| | - Ted Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, Seattle, WA 98109
| | - Fernanda Volt
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris
| | - Chantal Kenzey
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris
| | | | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, Seattle, WA 98109
| | - Sergio Querol
- Cell Therapy Services, Catalan Blood and Tissue Bank, Barcelona
| | - Hanadi Rafii
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris
| | - Vanderson Rocha
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France; Hospital das Clínicas and LIM31, Faculty of Medicine University of São Paulo
| | - Ryad Tamouza
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France; INSERM U955, CHU Henri Mondor, Créteil
| | - Christian Chabannon
- Institut Paoli-Calmettes, Inserm CBT1409, Marseille, France; Cellular Therapy and Immunobiology Working Party of the European Society for Blood and Marrow Transplantation, Leiden
| | - Annalisa Ruggeri
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France; Cellular Therapy and Immunobiology Working Party of the European Society for Blood and Marrow Transplantation, Leiden, The Netherlands; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan
| | - Eliane Gluckman
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France; Monacord, International Observatory on Sickle Cell Disease, Centre Scientifique de Monaco
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Schöne B, Bergmann S, Lang K, Wagner I, Schmidt AH, Petersdorf EW, Lange V. Corrigendum to "Predicting an HLA-DPB1 expression marker based on standard DPB1 genotyping: Linkage analysis of over 32,000 samples" [Hum. Immunol. 79 (2018) 20-27]. Hum Immunol 2020; 81:661. [PMID: 32977983 DOI: 10.1016/j.humimm.2020.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Bianca Schöne
- DKMS Life Science Lab, Blasewitzer Str. 43, 01307 Dresden, Germany
| | - Sabine Bergmann
- DKMS Life Science Lab, Blasewitzer Str. 43, 01307 Dresden, Germany
| | - Kathrin Lang
- DKMS Life Science Lab, Blasewitzer Str. 43, 01307 Dresden, Germany
| | - Ines Wagner
- DKMS Life Science Lab, Blasewitzer Str. 43, 01307 Dresden, Germany
| | - Alexander H Schmidt
- DKMS Life Science Lab, Blasewitzer Str. 43, 01307 Dresden, Germany; DKMS, Kressbach 1, 72072 Tübingen, Germany
| | - Effie W Petersdorf
- University of Washington, Fred Hutchinson Cancer Research Centre, Seattle, WA, United States
| | - Vinzenz Lange
- DKMS Life Science Lab, Blasewitzer Str. 43, 01307 Dresden, Germany.
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Petersdorf EW, Stevenson P, Bengtsson M, De Santis D, Dubois V, Gooley T, Horowitz M, Hsu K, Madrigal JA, Malkki M, McKallor C, Morishima Y, Oudshoorn M, Spellman SR, Villard J, Carrington M. HLA-B leader and survivorship after HLA-mismatched unrelated donor transplantation. Blood 2020; 136:362-369. [PMID: 32483623 PMCID: PMC7365916 DOI: 10.1182/blood.2020005743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/02/2020] [Indexed: 11/20/2022] Open
Abstract
Hematopoietic cell transplantation (HCT) from HLA-mismatched unrelated donors can cure life-threatening blood disorders, but its success is limited by graft-versus-host disease (GVHD). HLA-B leaders encode methionine (M) or threonine (T) at position 2 and give rise to TT, MT, or MM genotypes. The dimorphic HLA-B leader informs GVHD risk in HLA-B-mismatched HCT. If the leader influences outcome in other HLA-mismatched transplant settings, the success of HCT could be improved for future patients. We determined leader genotypes for 10 415 patients receiving a transplant between 1988 and 2016 from unrelated donors with one HLA-A, HLA-B, HLA-C, HLA-DRB1, or HLA-DQB1 mismatch. Multivariate regression methods were used to evaluate risks associated with patient leader genotype according to the mismatched HLA locus and with HLA-A, HLA-B, HLA-C, HLA-DRB1, or HLA-DQB1 mismatching according to patient leader genotype. The impact of the patient leader genotype on acute GVHD and mortality varied across different mismatched HLA loci. Nonrelapse mortality was higher among HLA-DQB1-mismatched MM patients compared with HLA-DQB1-mismatched TT patients (hazard ratio, 1.35; P = .01). Grades III to IV GVHD risk was higher among HLA-DRB1-mismatched MM or MT patients compared with HLA-DRB1-mismatched TT patients (odds ratio, 2.52 and 1.51, respectively). Patients tolerated a single HLA-DQB1 mismatch better than mismatches at other loci. Outcome after HLA-mismatched transplantation depends on the HLA-B leader dimorphism and the mismatched HLA locus. The patient's leader variant provides new information on the limits of HLA mismatching. The success of HLA-mismatched unrelated transplantation might be enhanced through the judicious selection of mismatched donors for a patient's leader genotype.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | - Philip Stevenson
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mats Bengtsson
- Department of Immunology, Genetics and Pathology, University of Uppsala, Uppsala, Sweden
| | | | - Valerie Dubois
- Etablissement Français du Sang Auvergne Rhône Alpes, Lyon, France
| | - Ted Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mary Horowitz
- Center for International Blood and Marrow Transplant Research, Milwaukee, WI
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Katharine Hsu
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Machteld Oudshoorn
- Leiden University Medical Centre, Leiden, The Netherlands
- Matchis Foundation, Leiden, The Netherlands
| | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | | | - Mary Carrington
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD; and
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard, Cambridge, MA
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15
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Petersdorf EW, Bengtsson M, De Santis D, Dubois V, Fleischhauer K, Gooley T, Horowitz M, Madrigal JA, Malkki M, McKallor C, Morishima Y, Oudshoorn M, Spellman SR, Villard J, Stevenson P, Carrington M. Role of HLA-DP Expression in Graft-Versus-Host Disease After Unrelated Donor Transplantation. J Clin Oncol 2020; 38:2712-2718. [PMID: 32479188 DOI: 10.1200/jco.20.00265] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
PURPOSE The main aim of this study was to evaluate the significance of HLA-DPB1 expression in acute graft-versus-host disease (GVHD) after hematopoietic cell transplantation (HCT) from HLA-A, -B, -C, -DRB1, -DQB1-matched and -mismatched unrelated donors. PATIENTS AND METHODS Between January 1, 2017, and January 10, 2019, we assessed 19,136 patients who received HCT from an HLA-A, -B, -C, -DRB1, -DQB1-matched or -mismatched unrelated donor performed in Australia, the European Union, Japan, North America, and the United Kingdom between 1988 and 2016. Among transplant recipients with one HLA-DPB1 mismatch, the patient's mismatched HLA-DPB1 allotype was defined as low or high expression. Multivariable regression models were used to assess risks of GVHD associated with high expression relative to low expression HLA-DPB1 mismatches. The effect of increasing numbers of HLA-DPB1 mismatches on clinical outcome was assessed in HLA-mismatched transplant recipients. RESULTS In HLA-A, -B, -C, -DRB1,-DQB1-matched transplant recipients, donor mismatching against one high-expression patient HLA-DPB1 increased moderate (odds ratio [OR], 1.36; P = .001) and severe acute GVHD (OR, 1.32; P = .0016) relative to low-expression patient mismatches, regardless of the expression level of the donor's mismatched HLA-DPB1. Among transplant recipients with one HLA-A, -B, -C, -DRB1, or -DQB1 mismatch, the odds of acute GVHD increased with increasing numbers of HLA-DPB1 mismatches (OR, 1.23 for one; OR, 1.40 for two mismatches relative to zero mismatches for moderate GVHD; OR, 1.19 for one; OR, 1.40 for two mismatches relative to zero for severe GVHD), but not with the level of expression of the patient's mismatched HLA-DPB1 allotype. CONCLUSION The level of expression of patient HLA-DPB1 mismatches informs the risk of GVHD after HLA-A, -B, -C, -DRB1, -DQB1-matched unrelated HCT, and the total number of HLA-DPB1 mismatches informs the risk of GVHD after HLA-mismatched unrelated HCT. Prospective consideration of HLA-DPB1 may help to lower GVHD risks after transplantation.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.,Department of Medicine, University of Washington, Seattle, WA
| | - Mats Bengtsson
- Department of Immunology, Genetics, and Pathology, University of Uppsala, Uppsala, Sweden
| | | | - Valerie Dubois
- Etablissement Français du Sang Auvergne Rhône Alpes, site de Lyon, Décines, France
| | - Katharina Fleischhauer
- Institute for Experimental Cellular Therapy, University of Duisburg-Essen, Essen, Germany
| | - Ted Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mary Horowitz
- Center for International Blood and Marrow Transplant Research, Milwaukee, WI.,Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI
| | | | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Yasuo Morishima
- Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Machteld Oudshoorn
- Leiden University Medical Centre, Department Immunohematology and Blood Transfusion, Leiden, the Netherlands.,Matchis Foundation, Leiden, the Netherlands
| | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | | | - Phil Stevenson
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mary Carrington
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD.,Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA
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16
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Martin PJ, Petersdorf EW. In Memoriam: John A. Hansen. Bone Marrow Transplant 2020. [DOI: 10.1038/s41409-019-0724-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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17
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Petersdorf EW, Carrington M, O'hUigin C, Bengtsson M, De Santis D, Dubois V, Gooley T, Horowitz M, Hsu K, Madrigal JA, Maiers MJ, Malkki M, McKallor C, Morishima Y, Oudshoorn M, Spellman SR, Villard J, Stevenson P. Role of HLA-B exon 1 in graft-versus-host disease after unrelated haemopoietic cell transplantation: a retrospective cohort study. Lancet Haematol 2019; 7:e50-e60. [PMID: 31669248 DOI: 10.1016/s2352-3026(19)30208-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/26/2019] [Accepted: 07/31/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND The success of unrelated haemopoietic cell transplantation (HCT) is limited by graft-versus-host disease (GVHD), which is the main post-transplantation challenge when HLA-matched donors are unavailable. A sequence dimorphism in exon 1 of HLA-B gives rise to leader peptides containing methionine (Met; M) or threonine (Thr; T), which differentially influence natural killer and T-cell alloresponses. The main aim of the study was to evaluate the role of the leader dimorphism in GVHD after HLA-B-mismatched unrelated HCT. METHODS We did a retrospective cohort study of 33 982 patients who received an unrelated HCT done in Australia, Europe, Japan, North America, and the UK between Jan 1, 1988, and Dec 31, 2016. Data were contributed by participants of the International Histocompatibility Working Group in Hematopoietic Cell Transplantation. All cases were included and there were no exclusion criteria. Multivariate regression models were used to assess risks associated with HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 mismatching. Among the 33 982 transplantations, the risks of GVHD associated with HLA-B M and T leaders were established in 17 100 (50·3%) HLA-matched and 1457 (4·3%) single HLA-B-mismatched transplantations using multivariate regression models. Leader frequencies were defined in 2 004 742 BeTheMatch US registry donors. FINDINGS Between Jan 20, 2017, and March 11, 2019, we assessed 33 982 HCTs using multivariate regression models for the role of HLA mismatching on outcome. Median follow-up was 1841 days (IQR 909-2963). Mortality and GVHD increased with increasing numbers of HLA mismatches. A single HLA-B mismatch increased grade 3-4 acute GVHD (odds ratio [OR] 1·89, 95% CI 1·53-2·33; p<0·0001). Among the single HLA-B-mismatched transplantations, acute GVHD risk was higher with leader mismatching than with leader matching (OR 1·73, 1·02-2·94; p=0·042 for grade 2-4) and with an M leader shared allotype compared with a T leader shared allotype (OR 1·98, 1·39-2·81; p=0·0001 for grade 3-4). The preferred HLA-B-mismatched donor is leader-matched and shares a T leader allotype. The majority (1 836 939 [91·6%]) of the 2 004 742 US registry donors have the TT or MT genotype. INTERPRETATION The HLA-B leader informs GVHD risk after HLA-B-mismatched unrelated HCT and differentiates high-risk HLA-B mismatches from those with lower risk. The leader of the matched allotype could be considered to be as important as the leader of the mismatched allotype for GVHD. Prospective identification of leader-matched donors is feasible for most patients in need of a HCT, and could lower GVHD and increase availability of HCT therapy. These findings are being independently validated and warrant further research in prospective trials. FUNDING The National Institutes of Health, USA.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA.
| | - Mary Carrington
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA; Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Colm O'hUigin
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Mats Bengtsson
- Department of Immunology, Genetics and Pathology, University of Uppsala, Uppsala, Sweden
| | | | - Valerie Dubois
- Etablissement Français du Sang Auvergne Rhône Alpes, site de Lyon, Décines, France
| | - Ted Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Mary Horowitz
- Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA; Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Katharine Hsu
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Martin J Maiers
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yasuo Morishima
- Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Machteld Oudshoorn
- Leiden University Medical Centre, Department Immunohematology and Blood Transfusion, Leiden, Netherlands; Matchis Foundation, Leiden, Netherlands
| | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | | | - Phil Stevenson
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Martin PJ, Petersdorf EW. In Memoriam: John A. Hansen (1943-2019). HLA 2019; 94:405-406. [PMID: 31507090 DOI: 10.1111/tan.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Paul J Martin
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
| | - Effie W Petersdorf
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
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Fatobene G, Storer BE, Salit RB, Lee SJ, Martin PJ, Cheng GS, Carpenter PA, Balgansuren G, Petersdorf EW, Delaney C, Sandmaier BM, Milano F, Flowers ME. Disability related to chronic graft - versus-host disease after alternative donor hematopoietic cell transplantation. Haematologica 2018; 104:835-843. [PMID: 30442722 PMCID: PMC6442956 DOI: 10.3324/haematol.2018.202754] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/08/2018] [Indexed: 12/21/2022] Open
Abstract
We determined the incidence of disability related to chronic graft-versus-host disease (bronchiolitis obliterans, grade ≥2 keratoconjunctivitis sicca, sclerotic features or esophageal stricture) for three categories of alternative donor: cord blood, haplorelated marrow or peripheral blood with post-transplant cyclophosphamide, and unrelated single HLA-allele mismatched peripheral blood. Among 396 consecutive hematopoietic cell transplant recipients, 129 developed chronic graft-versus-host disease with 3-year cumulative incidences of 8% for cord blood, 24% for haplorelated grafts, and 55% for unrelated single HLA-allele mismatched peripheral blood. Disability rates were significantly lower for cord blood [hazard ratio (HR) 0.13; 95% confidence interval (CI): 0.1-0.4] and for the haplorelated group (HR 0.31; 95% CI: 0.1-0.7) compared to the rate in the group transplanted with unrelated single HLA-allele mismatched peripheral blood. Cord blood recipients were also >2-fold more likely to return to work/school within 3 years from the onset of chronic graft-versus-host disease (HR 2.54; 95% CI: 1.1-5.7, P=0.02), and the haplorelated group trended similarly (HR 2.38; 95% CI: 1.0-5.9, P=0.06). Cord blood recipients were more likely to discontinue immunosuppression than were recipients of unrelated single HLA-allele mismatched peripheral blood (HR 3.96; 95% CI: 1.9-8.4, P=0.0003), similarly to the haplorelated group (HR 4.93; 95% CI: 2.2-11.1, P=0.0001). Progression-free survival and non-relapse mortality did not differ between groups grafted from different types of donors. Our observations that, compared to recipients of unrelated single HLA-allele mismatched peripheral blood, recipients of cord blood and haplorelated grafts less often developed disability related to chronic graft-versus-host disease, and were more likely to resume work/school, should help better counseling of pre-hematopoietic cell transplant candidates.
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Affiliation(s)
- Giancarlo Fatobene
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,Universidade de Sao Paulo, Hospital das Clinicas, SP, Brazil
| | - Barry E Storer
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
| | - Rachel B Salit
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Stephanie J Lee
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Paul J Martin
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Guang-Shing Cheng
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Paul A Carpenter
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Gansuvd Balgansuren
- University of Washington, Division of Medical Oncology, Seattle, WA, USA.,Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Effie W Petersdorf
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Colleen Delaney
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Brenda M Sandmaier
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Filippo Milano
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,University of Washington, Division of Medical Oncology, Seattle, WA, USA
| | - Mary E Flowers
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA .,University of Washington, Division of Medical Oncology, Seattle, WA, USA
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Petersdorf EW, Stevenson P, Malkki M, Strong RK, Spellman SR, Haagenson MD, Horowitz MM, Gooley T, Wang T. Patient HLA Germline Variation and Transplant Survivorship. J Clin Oncol 2018; 36:2524-2531. [PMID: 29902106 DOI: 10.1200/jco.2017.77.6534] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose HLA mismatching increases mortality after unrelated donor hematopoietic cell transplantation. The role of the patient's germline variation on survival is not known. Patients and Methods We previously identified 12 single nucleotide polymorphisms within the HLA region as markers of transplantation determinants and tested these in an independent cohort of 1,555 HLA-mismatched unrelated transplants. Linkage disequilibrium mapping across class II identified candidate susceptibility features. The candidate gene was confirmed in an independent cohort of 3,061 patients. Results Patient rs429916AA/AC was associated with increased transplantation-related mortality compared with rs429916CC (hazard ratio [HR], 1.39; 95% CI, 1.12 to 1.73; P = .003); rs429916A positivity was a proxy for DOA*01:01:05. Mortality increased with one (HR, 1.17; 95% CI, 1.0 to 1.36; P = .05) and two (HR, 2.51; 95% CI, 1.41 to 4.45; P = .002) DOA*01:01:05 alleles. HLA-DOA*01:01:05 was a proxy for HLA-DRB1 alleles encoding FEY ( P < 10E-15) and FDH ( P < 10E-15) amino acid substitutions at residues 26/28/30 that influence HLA-DRβ peptide repertoire. FEY- and FDH-positive alleles were positively associated with rs429916A ( P < 10E-15); FDY-positive alleles were negatively associated. Mortality was increased with FEY (HR, 1.66; 95% CI, 1.29 to 2.13; P = .00008) and FDH (HR, 1.40; 95% CI, 1.02 to 1.93; P = .04), whereas FDY was protective (HR, 0.88; 95% CI, 0.78 to 0.98; P = .02). Of the three candidate motifs, FEY was validated as the susceptibility determinant for mortality (HR, 1.29; 95% CI, 1.00 to 1.67; P = .05). Although FEY was found frequently among African and Hispanic Americans, it increased mortality independently of ancestry. Conclusion Patient germline HLA-DRB1 alleles that encode amino acid substitutions that influence the peptide repertoire of HLA-DRβ predispose to increased death after transplantation. Patient germline variation informs transplantation outcomes across US populations and may provide a means to reduce risks for high-risk patients through pretransplantation screening and evaluation.
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Affiliation(s)
- Effie W Petersdorf
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
| | - Philip Stevenson
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
| | - Mari Malkki
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
| | - Roland K Strong
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
| | - Stephen R Spellman
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
| | - Michael D Haagenson
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
| | - Mary M Horowitz
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
| | - Ted Gooley
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
| | - Tao Wang
- Effie W. Petersdorf, University of Washington; Fred Hutchinson Cancer Research Center; Philip Stevenson, Mari Malkki, Roland K. Strong, Ted Gooley, Fred Hutchinson Cancer Research Center, Seattle, WA; Stephen R. Spellman, Michael D. Haagenson, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Mary M. Horowitz, Tao Wang, Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, WI
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Abstract
The availability of hematopoietic cell transplantation as curative therapy for blood disorders has been dramatically improved through a better understanding of the human leukocyte antigen (HLA) barrier. Although a fully compatible unrelated donor is preferable, transplantation from donors with a limited degree of HLA mismatching is associated with acceptable outcomes in many cases. Research on the limits of HLA mismatching, and the features that define permissible HLA mismatches will continue to enable transplantation to be more broadly available to patients in need.
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Affiliation(s)
- E W Petersdorf
- Fred Hutchinson Cancer Research Center, Division of Clinical Research, Seattle, Washington
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22
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El-Jawahri A, LeBlanc TW, Burns LJ, Denzen EM, Meyer C, Mau LW, Roeland E, Wood WA, Petersdorf EW. Barriers to palliative care (PC) utilization in hematopoietic stem cell transplantation (HCT). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.10116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Linda J. Burns
- National Marrow Donor Program/Be The Match and Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Ellen M. Denzen
- National Marrow Donor Program/Be The Match and Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Christa Meyer
- National Marrow Donor Program/Be The Match and Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Lih-Wen Mau
- National Marrow Donor Program/ Be The Match and Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Eric Roeland
- University of California San Diego Moores Cancer Center, La Jolla, CA
| | - William Allen Wood
- University of North Carolina, Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC
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23
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Eaton KD, Romine PE, Goodman GE, Thornquist MD, Barnett MJ, Petersdorf EW. Inflammatory Gene Polymorphisms in Lung Cancer Susceptibility. J Thorac Oncol 2018; 13:649-659. [PMID: 29408308 DOI: 10.1016/j.jtho.2018.01.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 01/09/2018] [Accepted: 01/26/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Chronic inflammation has been implicated in carcinogenesis, with increasing evidence of its role in lung cancer. We aimed to evaluate the role of genetic polymorphisms in inflammation-related genes in the risk for development of lung cancer. METHODS A nested case-control study design was used, and 625 cases and 625 well-matched controls were selected from participants in the β-Carotene and Retinol Efficacy Trial, which is a large, prospective lung cancer chemoprevention trial. The association between lung cancer incidence and survival and 23 polymorphisms descriptive of 11 inflammation-related genes (interferon gamma gene [IFNG], interleukin 10 gene [IL10], interleukin 1 alpha gene [IL1A], interleukin 1 beta gene [IL1B], interleukin 2 gene [IL2], interleukin 4 receptor gene [IL4R], interleukin 4 gene [IL4], interleukin 6 gene [IL6], prostaglandin-endoperoxide synthase 2 gene [PTGS2] (also known as COX2), transforming growth factor beta 1 gene [TGFB1], and tumor necrosis factor alpha gene [TNFA]) was evaluated. RESULTS Of the 23 polymorphisms, two were associated with risk for lung cancer. Compared with individuals with the wild-type (CC) variant, individuals carrying the minor allele variants of the IL-1β-511C>T promoter polymorphism (rs16944) (CT and TT) had decreased odds of lung cancer (OR = 0.74, [95% confidence interval (CI): 0.58-0.94] and OR = 0.71 [95% CI: 0.50-1.01], respectively, p = 0.03). Similar results were observed for the IL-1β-1464 C>G promoter polymorphism (rs1143623), with presence of the minor variants CG and CC having decreased odds of lung cancer (OR = 0.75 [95% CI: 0.59-0.95] and OR = 0.69 [95% CI: 0.46-1.03], respectively, p = 0.03). Survival was not influenced by genotype. CONCLUSIONS This study provides further evidence that IL1B promoter polymorphisms may modulate the risk for development of lung cancer.
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Affiliation(s)
- Keith D Eaton
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medicine, University of Washington, Seattle, Washington.
| | - Perrin E Romine
- Department of Medicine, University of Washington, Seattle, Washington
| | - Gary E Goodman
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mark D Thornquist
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Biostatistics, University of Washington, Seattle, Washington
| | - Matt J Barnett
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Effie W Petersdorf
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medicine, University of Washington, Seattle, Washington
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24
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El-Jawahri AR, LeBlanc TW, Burns LJ, Denzen EM, Meyer C, Mau LW, Roeland E, Wood WA, Petersdorf EW. A National Survey Study of Transplant Physicians' Attitudes About Palliative Care. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abdel-Wahab O, Abrahm JL, Adams S, Adewoye AH, Allen C, Ambinder RF, Anasetti C, Anastasi J, Anderson JA, Antin JH, Antony AC, Araten DJ, Armand P, Armstrong G, Armstrong SA, Arnold DM, Artz AS, Awan FT, Baglin TP, Benson DM, Benz EJ, Berliner N, Bhagat G, Bhardwaj N, Bhatia R, Bhatia S, Bhatt MD, Bhatt VR, Bitan M, Blinderman CD, Bollard CM, Braun BS, Brenner MK, Brittenham GM, Brodsky RA, Brown M, Broxmeyer HE, Brummel-Ziedins K, Brunner AM, Buadi FK, Burkhardt B, Burns M, Byrd JC, Caimi PF, Caligiuri MA, Canavan M, Cantor AB, Carcao M, Carroll MC, Carty SA, Castillo JJ, Chan AK, Chapin J, Chiu A, Chute JP, Clark DB, Coates TD, Cogle CR, Connell NT, Cooke E, Cooley S, Corradini P, Creager MA, Creger RJ, Cromwell C, Crowther MA, Cushing MM, Cutler C, Dang CV, Danial NN, Dave SS, DeCaprio JA, Dinauer MC, Dinner S, Diz-Küçükkaya R, Dodd RY, Donato ML, Dorshkind K, Dotti G, Dror Y, Dunleavy K, Dvorak CC, Ebert BL, Eck MJ, Eikelboom JW, Epperla N, Ershler WB, Evans WE, Faderl S, Ferrara JL, Filipovich AH, Fischer M, Fredenburgh JC, Friedman KD, Fuchs E, Fuller SJ, Gailani D, Galipeau J, Gallagher PG, Ganapathi KA, Gardner LB, Gee AP, Gerson SL, Gertz MA, Giardina PJ, Gibson CJ, Golan K, Golub TR, Gonzales MJ, Gotlib J, Gottschalk S, Grant MA, Graubert TA, Gregg XT, Gribben JG, Gross DM, Gruber TA, Guitart J, Gurbuxani S, Gur-Cohen S, Gutierrez A, Hamadani M, Hari PN, Hartwig JH, Hayman SR, Hayward CP, Hebbel RP, Heslop HE, Hillis C, Hillyer CD, Ho K, Hockenbery DM, Hoffman R, Hogg KE, Holtan SG, Horny HP, Hsu YMS, Hunter ZR, Huntington JA, Iancu-Rubin C, Iqbal A, Isenman DE, Israels SJ, Italiano JE, Jaffe ES, Jaffer IH, Jagannath S, Jäger U, Jain N, James P, Jeha S, Jordan MB, Josephson CD, Jung M, Kager L, Kambayashi T, Kanakry JA, Kantarjian HM, Kaplan J, Karafin MS, Karsan A, Kaufman RJ, Kaufman RM, Keller FG, Kelly KM, Kessler CM, Key NS, Keyzner A, Khandoga AG, Khanna-Gupta A, Khatib-Massalha E, Klein HG, Knoechel B, Kollet O, Konkle BA, Kontoyiannis DP, Koreth J, Koretzky GA, Kotecha D, Kremyanskaya M, Kumari A, Kuzel TM, Küppers R, Lacy MQ, Ladas E, Landier W, Lapid K, Lapidot T, Larson PJ, Levi M, Lewis RE, Liebman HA, Lillicrap D, Lim W, Lin JC, Lindblad R, Lip GY, Little JA, Lohr JG, López JA, Luscinskas FW, Maciejewski JP, Majhail NS, Manches O, Mandle RJ, Mann KG, Manno CS, Marcogliese AN, Mariani G, Marincola FM, Mascarenhas J, Massberg S, McEver RP, McGrath E, McKinney MS, Mehta RS, Mentzer WC, Merlini G, Merryman R, Michel M, Migliaccio AR, Miller JS, Mims MP, Mondoro TH, Moorehead P, Muniz LR, Munshi NC, Najfeld V, Nayak L, Nazy I, Neff AT, Ness PM, Notarangelo LD, O'Brien SH, O'Connor OA, O'Donnell M, Olson A, Orkin SH, Pai M, Pai SY, Paidas M, Panch SR, Pande RL, Papayannopoulou T, Parikh R, Petersdorf EW, Peterson SE, Pittaluga S, Ponce DM, Popolo L, Prchal JT, Pui CH, Puigserver P, Rak J, Ramos CA, Rand JH, Rand ML, Rao DS, Ravandi F, Rawlings DJ, Reddy P, Reding MT, Reiter A, Rice L, Riese MJ, Ritchey AK, Roberts DJ, Roman E, Rooney CM, Rosen ST, Rosenthal DS, Rossmann MP, Rot A, Rowley SD, Rubnitz JE, Rydz N, Salama ME, Sauk S, Saunthararajah Y, Savage W, Scadden D, Schaefer KG, Schiffman F, Schneidewend R, Schrier SL, Schuchman EH, Scullion BF, Selvaggi KJ, Senoo K, Shaheen M, Shaz BH, Shelburne SA, Shpall EJ, Shurin SB, Siegal D, Silberstein LE, Silberstein L, Silverstein RL, Sloan SR, Smith FO, Smith JW, Smith K, Steensma DP, Steinberg MH, Stock W, Storry JR, Stramer SL, Strauss RG, Stroncek DF, Taylor J, Thota S, Treon SP, Tulpule A, Valdes RF, Valent P, Vedantham S, Vercellotti GM, Verneris MR, Vichinsky EP, von Andrian UH, Vose JM, Wagner AJ, Wang E, Wang JH, Warkentin TE, Wasserstein MP, Webster A, Weisdorf DJ, Weitz JI, Westhoff CM, Wheeler AP, Widick P, Wiley JS, William BM, Williams DA, Wilson WH, Wolfe J, Wolgast LR, Wood D, Wu J, Yahalom J, Yee DL, Younes A, Young NS, Zeller MP. Contributors. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00168-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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26
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Petersdorf EW, Anasetti C. Unrelated Donor Hematopoietic Cell Transplantation. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Samuelson Bannow BT, Salit RB, Storer BE, Stevens EA, Wu D, Yeung C, Fang M, Petersdorf EW, Linenberger ML, Woo J, Sorror ML, Doney K, Sandmaier BM, Deeg HJ, Scott BL. Hematopoietic Cell Transplantation for Myelofibrosis: the Dynamic International Prognostic Scoring System Plus Risk Predicts Post-Transplant Outcomes. Biol Blood Marrow Transplant 2017; 24:386-392. [PMID: 28970176 DOI: 10.1016/j.bbmt.2017.09.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 09/21/2017] [Indexed: 01/21/2023]
Abstract
Hematopoietic cell transplantation (HCT) provides potentially curative treatment for patients with myelofibrosis (MF). HCT outcomes are associated with the Dynamic International Prognostic Scoring System (DIPSS) risk scores. In the present study we analyzed results in 233 patients to determine if the DIPSS plus classification, which adds cytogenetics, thrombocytopenia, and RBC transfusion dependence as risk factors, would better predict post-HCT outcomes than the original DIPSS. Multivariate analysis showed that each risk parameter incorporated into the DIPPS plus model contributed to its predictive power of overall mortality, relapse-free survival, and nonrelapse mortality. The 5-year overall survival (OS), relapse, and treatment-related mortality (TRM) rates for patients with low/intermediate-1 risk MF were 78%, 5%, and 20%, respectively. The 5-year OS, relapse, and TRM rates for patients with high-risk MF were 35%, 28%, and 40%, respectively. The HCT-specific comorbidity index of 3 or greater was associated with higher nonrelapse and overall mortality and reduced relapse-free survival. The relapse incidence was significantly increased in older patients (HR, 3.02; P = .0007). With a median follow-up of 8 years 124 patients (53%) were surviving. The components of the DIPSS plus classification still have prognostic relevance after adjustment by the DIPSS classification. This information should enhance our ability to advise patients when making decisions regarding timing of transplant.
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Affiliation(s)
- Bethany T Samuelson Bannow
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Rachel B Salit
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Barry E Storer
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Emily A Stevens
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - David Wu
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Cecilia Yeung
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Min Fang
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Effie W Petersdorf
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Michael L Linenberger
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Janghee Woo
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Mohamed L Sorror
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Kris Doney
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Brenda M Sandmaier
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - H Joachim Deeg
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington
| | - Bart L Scott
- Fred Hutchinson Cancer Research Center, the University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, Washington.
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28
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Abstract
The sheer diversity of HLA alleles makes the probability of finding matched unrelated donors for patients requiring hematopoietic cell transplantation (HCT) a complex situation. New evidence suggests that mismatching at certain HLA loci may provide a greater benefit in terms of graft-versus-leukemia effect than other mismatches when HLA-matched donors are not available. This review summarizes the current understanding of HLA matching requirements for unrelated donor HCT.
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Affiliation(s)
- Effie W Petersdorf
- University of Washington School of Medicine, 1959 NE Pacific St., Seattle, WA 98195, USA; Fred Hutchinson Cancer Research Center, Division of Clinical Research, 1100 Fairview Ave North, Seattle, WA 98109, USA.
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29
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Boudreau JE, Giglio F, Gooley TA, Stevenson PA, Le Luduec JB, Shaffer BC, Rajalingam R, Hou L, Hurley CK, Noreen H, Reed EF, Yu N, Vierra-Green C, Haagenson M, Malkki M, Petersdorf EW, Spellman S, Hsu KC. KIR3DL1/HLA-B Subtypes Govern Acute Myelogenous Leukemia Relapse After Hematopoietic Cell Transplantation. J Clin Oncol 2017; 35:2268-2278. [PMID: 28520526 DOI: 10.1200/jco.2016.70.7059] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Disease relapse remains a major challenge to successful outcomes in patients who undergo allogeneic hematopoietic cell transplantation (HCT). Donor natural killer (NK) cell alloreactivity in HCT can control leukemic relapse, but capturing alloreactivity in HLA-matched HCT has been elusive. HLA expression on leukemia cells-upregulated in the post-HCT environment-signals for NK cell inhibition via inhibitory killer immunoglobulin-like (KIR) receptors and interrupts their antitumor activity. We hypothesized that varied strengths of inhibition among subtypes of the ubiquitous KIR3DL1 and its cognate ligand, HLA-B, would titrate NK reactivity against acute myelogenous leukemia (AML). Patients and Methods By using an algorithm that was based on polymorphism-driven expression levels and specificities, we predicted and tested inhibitory and cytotoxic NK potential on the basis of KIR3DL1/HLA-B subtype combinations in vitro and evaluated their impact in 1,328 patients with AML who underwent HCT from 9/10 or 10/10 HLA-matched unrelated donors. Results Segregated by KIR3DL1 subtype, NK cells demonstrated reproducible patterns of strong, weak, or noninhibition by target cells with defined HLA-B subtypes, which translated into discrete cytotoxic hierarchies against AML. In patients, KIR3DL1 and HLA-B subtype combinations that were predictive of weak inhibition or noninhibition were associated with significantly lower relapse (hazard ratio [HR], 0.72; P = .004) and overall mortality (HR, 0.84; P = .030) compared with strong inhibition combinations. The greatest effects were evident in the high-risk group of patients with all KIR ligands (relapse: HR, 0.54; P < .001; and mortality: HR, 0.74; P < .008). Beneficial effects of weak and noninhibiting KIR3DL1 and HLA-B subtype combinations were separate from and additive to the benefit of donor activating KIR2DS1. Conclusion Consideration of KIR3DL1-mediated inhibition in donor selection for HLA-matched HCT may achieve superior graft versus leukemia effects, lower risk for relapse, and an increase in survival among patients with AML.
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Affiliation(s)
- Jeanette E Boudreau
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Fabio Giglio
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Ted A Gooley
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Philip A Stevenson
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Jean-Benoît Le Luduec
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Brian C Shaffer
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Raja Rajalingam
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Lihua Hou
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Carolyn Katovich Hurley
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Harriet Noreen
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Elaine F Reed
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Neng Yu
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Cynthia Vierra-Green
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Michael Haagenson
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Mari Malkki
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Effie W Petersdorf
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Stephen Spellman
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
| | - Katharine C Hsu
- Jeanette E. Boudreau, Fabio Giglio, Jean-Benoît Le Luduec, Brian C. Shaffer, and Katharine C. Hsu, Memorial Sloan Kettering Cancer Center; Brian C. Shaffer and Katharine C. Hsu, Weill Cornell Medical College, New York, NY; Ted A. Gooley, Philip A. Stevenson, Mari Malkki, and Effie W. Petersdorf, Fred Hutchinson Cancer Research Center, Seattle, WA; Raja Rajalingam, University of California, San Francisco, San Francisco; Elaine F. Reed, University of California, Los Angeles, Los Angeles, CA; Lihua Hou and Carolyn Katovich Hurley, Georgetown University Medical Center, Washington, DC; Harriet Noreen, University of Minnesota; Cynthia Vierra-Green, Michael Haagenson, and Stephen Spellman, Center for International Blood and Marrow Transplant Research, Minneapolis, MN; and Neng Yu, American Red Cross Blood Services, Dedham, MA
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Abstract
Graft-versus-host disease (GVHD) remains a significant potentially life-threatening complication of allogeneic hematopoietic cell transplantation (HCT). Since the discovery of the human leukocyte antigen (HLA) system over 50 years ago, significant advances have clarified the nature of HLA variation between transplant recipients and donors as a chief etiology of GVHD. New information on coding and non-coding gene variation and GVHD risk provides clinicians with options to consider selected mismatched donors when matched donors are not available. These advances have increased the availability of unrelated donors for patients in need of a transplant and have lowered the overall morbidity and mortality of HCT.
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Abstract
There are now more than 25 million volunteer donors registered worldwide for patients in need of a life-saving hematopoietic cell transplant to cure blood disorders. Although a human leukocyte antigen (HLA)-matched donor remains the preferred stem cell source for transplantation, the use of a donor with limited HLA mismatching may be considered. Significant advances in clinical and basic research have been instrumental in furthering the understanding of donor-recipient HLA mismatches that are better tolerated than other mismatches. An increased appreciation of the role of regulatory region variation that affects the level of HLA expression provides new approaches for the selection of HLA-mismatched donors.
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Affiliation(s)
- Effie W Petersdorf
- Department of Medicine, University of Washington; Seattle Cancer Care Alliance; Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.
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Brunstein CG, Petersdorf EW, DeFor TE, Noreen H, Maurer D, MacMillan ML, Ustun C, Verneris MR, Miller JS, Blazar BR, McGlave PB, Weisdorf DJ, Wagner JE. Impact of Allele-Level HLA Mismatch on Outcomes in Recipients of Double Umbilical Cord Blood Transplantation. Biol Blood Marrow Transplant 2015; 22:487-92. [PMID: 26431630 DOI: 10.1016/j.bbmt.2015.09.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 09/23/2015] [Indexed: 01/27/2023]
Abstract
The impact of allele-level HLA mismatch is uncertain in recipients of double umbilical cord blood (UCB) transplantation. We report a single-center retrospective study of the clinical effect of using allele-level HLA mismatch HLA-A, -B, -C, -DRB1, and -DQB1 of the 2 UCB units. We studied 342 patients with hematologic malignancy. Donor-recipient pairs were grouped according to the number of matched HLA alleles, with 32 matched at 9-10/10, 202 at 6-8/10, and 108 at 2-5/10 alleles. The incidence of hematopoietic recovery, acute and chronic graft-versus-host disease, and nonrelapse mortality and treatment failure was similar between groups. In an exploratory analysis of 174 patients with acute leukemia, after adjusting for length of first remission and cytogenetic risk group, a 2-5/10 HLA match was associated with lower risk of relapse and treatment failure. These data indicate that a high degree of allele-level HLA mismatch does not adversely affect transplant outcomes and may be associated with reduced relapse risk in patients with acute leukemia.
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Affiliation(s)
- Claudio G Brunstein
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota.
| | - Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Todd E DeFor
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Harriet Noreen
- Immunology Laboratory, University of Minnesota, Minneapolis, Minnesota
| | - David Maurer
- Immunology Laboratory, University of Minnesota, Minneapolis, Minnesota
| | - Margaret L MacMillan
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Celalettin Ustun
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Michael R Verneris
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Jeffrey S Miller
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Bruce R Blazar
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Philip B McGlave
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Daniel J Weisdorf
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - John E Wagner
- Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
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Deeg HJ, Bredeson C, Farnia S, Ballen K, Gupta V, Mesa RA, Popat U, Hari P, Saber W, Seftel M, Tamari R, Petersdorf EW. Hematopoietic Cell Transplantation as Curative Therapy for Patients with Myelofibrosis: Long-Term Success in all Age Groups. Biol Blood Marrow Transplant 2015; 21:1883-7. [PMID: 26371371 DOI: 10.1016/j.bbmt.2015.09.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 09/08/2015] [Indexed: 11/20/2022]
Abstract
Myeloproliferative neoplasms (MPN) are chronic marrow disorders with variable prognoses. Most patients with polycythemia vera, essential thrombocythemia, or even primary myelofibrosis (PMF) are successfully treated with conservative strategies for years or even decades, and recent data suggest that even in patients with high-risk disease, in particular those with PMF, life expectancy can be extended by treatment with janus kinase (JAK2) inhibitors. However, none of those modalities are curative, and after marrow failure develops, the disease "accelerates," or transforms to acute leukemia, the only option able to effectively treat and, in fact, cure MPN is allogeneic hematopoietic cell transplantation (HCT). Outcome is superior if HCT is performed before leukemic transformation occurs. Several reports document survival in unmaintained remission beyond 10 years. The most recent analyses show reduced regimen-related mortality (less than 10% or even 5% at day 100) and progressively improved survival with both HLA-identical sibling and unrelated donors. The development of low/reduced-intensity conditioning regimens has contributed to the improved success rate and has allowed successful HCT in patients in their seventh and even eighth decade of life. We propose, therefore, that HCT should be offered to fit patients in these age groups and should be covered by their respective insurance carriers.
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Affiliation(s)
- H Joachim Deeg
- Fred Hutchinson Cancer Research Center and the University of Washington School of Medicine, Seattle, Washington.
| | | | | | - Karen Ballen
- Hematology/Oncology Division, Massachusetts General Hospital, Boston, Massachusetts
| | - Vikas Gupta
- Medical Oncology and Hematology, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
| | - Ruben A Mesa
- Division of Hematology and Medical Oncology, Mayo Clinic Cancer Center, Scottsdale, Arizona
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Parameswaran Hari
- Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Wael Saber
- Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Matthew Seftel
- Section of Hematology/Oncology, University of Manitoba, Winnipeg, Canada
| | - Roni Tamari
- Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Effie W Petersdorf
- Fred Hutchinson Cancer Research Center and the University of Washington School of Medicine, Seattle, Washington
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Petersdorf EW, Malkki M, O'hUigin C, Carrington M, Gooley T, Haagenson MD, Horowitz MM, Spellman SR, Wang T, Stevenson P. High HLA-DP Expression and Graft-versus-Host Disease. N Engl J Med 2015; 373:599-609. [PMID: 26267621 PMCID: PMC4560117 DOI: 10.1056/nejmoa1500140] [Citation(s) in RCA: 207] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Transplantation of hematopoietic cells from unrelated donors can cure blood disorders but carries a significant risk of acute graft-versus-host disease (GVHD). The risk is higher when the recipient and donor are HLA-DPB1-mismatched, but the mechanisms leading to GVHD are unknown. The HLA-DPB1 regulatory region variant rs9277534 is associated with HLA-DPB1 expression. We tested the hypothesis that the GVHD risk correlates with the rs9277534 allele linked to the mismatched HLA-DPB1 in the recipient. METHODS We genotyped rs9277534 in 3505 persons to define rs9277534-DPB1 haplotypes. Among 1441 recipients of transplants from HLA-A,B,C,DRB1,DQB1-matched unrelated donors with only one HLA-DPB1 mismatch, linkage of the rs9277534 A and G alleles to the mismatched HLA-DPB1 was determined. HLA-DPB1 expression was assessed by means of a quantitative polymerase-chain-reaction assay. The risk of acute GVHD among recipients whose mismatched HLA-DPB1 allele was linked to rs9277534G (high expression) was compared with the risk among recipients whose mismatched HLA-DPB1 allele was linked to rs9277534A (low expression). RESULTS The mean HLA-DPB1 expression was lower with rs9277534A than with rs9277534G. Among recipients of transplants from donors with rs9277534A-linked HLA-DPB1, the risk of acute GVHD was higher for recipients with rs9277534G-linked HLA-DPB1 mismatches than for recipients with rs9277534A-linked HLA-DPB1 mismatches (hazard ratio, 1.54; 95% confidence interval [CI], 1.25 to 1.89; P<0.001), as was the risk of death due to causes other than disease recurrence (hazard ratio, 1.25; 95% CI, 1.00 to 1.57; P=0.05). CONCLUSIONS The risk of GVHD associated with HLA-DPB1 mismatching was influenced by the HLA-DPB1 rs9277534 expression marker. Among recipients of HLA-DPB1-mismatched transplants from donors with the low-expression allele, recipients with the high-expression allele had a high risk of GVHD. (Funded by the National Institutes of Health and others.).
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Affiliation(s)
- Effie W Petersdorf
- From the Division of Clinical Research, Fred Hutchinson Cancer Research Center (E.W.P., M.M., T.G., P.S.), and the Department of Medicine, University of Washington School of Medicine (E.W.P.) - both in Seattle; Cancer and Inflammation Program, Laboratory of Experimental Immunology, Leidos Biomedical Research, Frederick National Laboratories for Cancer Research, Frederick, MD (C.O., M.C.); Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Boston (M.C.); Center for International Blood and Marrow Transplant Research, Minneapolis (M.D.H., S.R.S.); and Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee (M.M.H., T.W.)
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35
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Hardikar S, Johnson LG, Malkki M, Petersdorf EW, Galloway DA, Schwartz SM, Madeleine MM. A population-based case-control study of genetic variation in cytokine genes associated with risk of cervical and vulvar cancers. Gynecol Oncol 2015; 139:90-6. [PMID: 26241630 DOI: 10.1016/j.ygyno.2015.07.110] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Persistent infection with oncogenic human papillomavirus (HPV) is known to be the necessary cause of cervical cancer and a majority of vulvar cancers. Persistent HPV infections must evade host immune responses, including cytokines released by activated T-helper (Th) cells. In this study, we investigated the risk of cervical and vulvar cancers associated with common genetic variations in 560 tagging single-nucleotide polymorphisms (SNPs) in candidate cytokine genes. METHODS The study included 399 invasive squamous cell carcinomas (SCCs) and 502 in situ or invasive adenocarcinomas (AC) of the cervix; 357 in situ or invasive vulvar SCC; and 1109 controls from the Seattle-area case-control studies of HPV-related cancers. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) using a log additive model, with adjustment for multiple testing. RESULTS Statistically significant risks were observed for HPV16-containing SCC of the cervix with the variant allele rs879576 in IL17RA and rs2229094 in TNF [OR, 95% CI and multiple-testing corrected p: 1.91 (1.30-2.79), p=0.018 and 0.61 (0.45-0.83), p=0.02, respectively]. We also observed significantly increased risk of HPV-positive vulvar cancers associated with variant alleles in CSF2 (rs25882 and rs27438, 26-28% increased risk) and IL-12B (rs2569254 and rs3181225, 40-41% increased risk) genes. CONCLUSIONS We found that variation in several Th-cytokine genes is significantly associated with cervical and vulvar cancer risk. The strong association between these HPV-related cancers and common variation in cytokine genes in the Th1 and Th17 pathways may be important for development of new therapies.
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Affiliation(s)
- Sheetal Hardikar
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Lisa G Johnson
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Mari Malkki
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Effie W Petersdorf
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Denise A Galloway
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stephen M Schwartz
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Margaret M Madeleine
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
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36
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Israeli M, Roelen DL, Carrington M, Petersdorf EW, Claas FH, Haasnoot GW, Oudshoorn M. LBOR03. Hum Immunol 2015. [DOI: 10.1016/j.humimm.2015.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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37
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Petersdorf EW, Gooley TA, Malkki M, Bacigalupo AP, Cesbron A, Du Toit E, Ehninger G, Egeland T, Fischer GF, Gervais T, Haagenson MD, Horowitz MM, Hsu K, Jindra P, Madrigal A, Oudshoorn M, Ringdén O, Schroeder ML, Spellman SR, Tiercy JM, Velardi A, Witt CS, O'Huigin C, Apps R, Carrington M. HLA-C expression levels define permissible mismatches in hematopoietic cell transplantation. Blood 2014; 124:3996-4003. [PMID: 25323824 PMCID: PMC4271183 DOI: 10.1182/blood-2014-09-599969] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 10/03/2014] [Indexed: 11/20/2022] Open
Abstract
Life-threatening graft-versus-host disease (GVHD) limits the use of HLA-C-mismatched unrelated donors in transplantation. Clinicians lack criteria for donor selection when HLA-C-mismatched donors are a patient's only option for cure. We examined the role for HLA-C expression levels to identify permissible HLA-C mismatches. The median fluorescence intensity, a proxy of HLA-C expression, was assigned to each HLA-C allotype in 1975 patients and their HLA-C-mismatched unrelated transplant donors. The association of outcome with the level of expression of patients' and donors' HLA-C allotypes was evaluated in multivariable models. Increasing expression level of the patient's mismatched HLA-C allotype was associated with increased risks of grades III to IV acute GVHD, nonrelapse mortality, and mortality. Increasing expression level among HLA-C mismatches with residue 116 or residue 77/80 mismatching was associated with increased nonrelapse mortality. The immunogenicity of HLA-C mismatches in unrelated donor transplantation is influenced by the expression level of the patient's mismatched HLA-C allotype. HLA-C expression levels provide new information on mismatches that should be avoided and extend understanding of HLA-C-mediated immune responses in human disease.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Theodore A Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Andrea P Bacigalupo
- Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Anne Cesbron
- Laboratoire d'Histocompatibilité et d'Immunogénétique, Etablissement Français du Sang Pays de Loire, Nantes, France
| | - Ernette Du Toit
- University of Cape Town, Cape Town and South African Bone Marrow Registry, Cape Town, South Africa
| | | | - Torstein Egeland
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Gottfried F Fischer
- Department for Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Thibaut Gervais
- Cliniques St. Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Michael D Haagenson
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Mary M Horowitz
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
| | - Katharine Hsu
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | - Alejandro Madrigal
- Anthony Nolan Research Institute, The Royal Free Hampstead NHS Trust, London, United Kingdom
| | - Machteld Oudshoorn
- Leiden University Medical Center and Europdonor Foundation, Leiden, The Netherlands
| | - Olle Ringdén
- Division of Therapeutic Immunology, Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Huddinge, Sweden
| | | | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Jean-Marie Tiercy
- National Reference Laboratory for Histocompatibility, Department of Genetics and Laboratory Medicine, University Hospital Geneva, Geneva, Switzerland
| | - Andrea Velardi
- European Group for Blood and Marrow Transplantation and University of Perugia, Perugia, Italy
| | - Campbell S Witt
- Department of Clinical Immunology, Royal Perth Hospital, Perth, Australia
| | - Colm O'Huigin
- Cancer and Inflammation Program, SAIC Frederick, Inc., Frederick National Laboratories for Cancer Research, Frederick, MD; and
| | - Richard Apps
- Cancer and Inflammation Program, SAIC Frederick, Inc., Frederick National Laboratories for Cancer Research, Frederick, MD; and Ragon Institute of the Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Boston, MA
| | - Mary Carrington
- Cancer and Inflammation Program, SAIC Frederick, Inc., Frederick National Laboratories for Cancer Research, Frederick, MD; and Ragon Institute of the Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Boston, MA
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Boyiadzis M, Arora M, Klein JP, Hassebroek A, Hemmer M, Urbano-Ispizua A, Antin JH, Bolwell BJ, Cahn JYY, Cairo MS, Cutler CS, Flowers ME, Gale RP, Herzig R, Isola LM, Jacobsohn DA, Jagasia MH, Klumpp TR, Lee SJ, Petersdorf EW, Santarone S, Spellman SR, Schouten HC, Verdonck LF, Wingard JR, Weisdorf DJ, Horowitz MM, Pavletic SZ. Impact of Chronic Graft-versus-Host Disease on Late Relapse and Survival on 7,489 Patients after Myeloablative Allogeneic Hematopoietic Cell Transplantation for Leukemia. Clin Cancer Res 2014; 21:2020-8. [PMID: 25348512 DOI: 10.1158/1078-0432.ccr-14-0586] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 09/21/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE Malignancy relapse remains a major obstacle for successful allogeneic hematopoietic cell transplantation (HCT). Chronic graft-versus-host disease (cGVHD) is associated with fewer relapses. However, when studying effects of cGVHD on relapse, it is difficult to separate from acute GVHD effects as most cases of cGVHD occur within the first year after transplant at the time when acute GVHD is still active. EXPERIMENTAL DESIGN This study based on CIBMTR registry data investigated cGVHD and its association with the incidence of late relapse and survival in 7,489 patients with acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myelogenous leukemia (CML), and myelodysplastic syndromes (MDS), who were leukemia free at 12 months after myeloablative allogeneic HCT. RESULTS Forty-seven percent of the study population was diagnosed with cGVHD at 12 months after transplant. The protective effect of cGVHD on late relapse was present only in patients with CML [RR, 0.47; 95% confidence interval (CI), 0.37-0.59; P < 0.0001). cGVHD was significantly associated with higher risk of treatment-related mortality (TRM; RR, 2.43; 95% CI, 2.09-2.82; P < 0.0001) and inferior overall survival (RR, 1.56; 95% CI, 1.41-1.73; P < 0.0001) for all diseases. In patients with CML, all organ sites and presentation types of cGVHD were equally associated with lower risk of late relapse. CONCLUSIONS These results indicate that clinically relevant antileukemia effects of cGVHD on late relapses are present only in CML but not in AML, ALL, or MDS. Chronic GVHD in patients who are 1-year survivors after myeloablative allogeneic HCT is primarily associated with higher TRM and inferior survival.
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Affiliation(s)
- Michael Boyiadzis
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Mukta Arora
- University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota
| | - John P Klein
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Anna Hassebroek
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | - Michael Hemmer
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | | | | | | | | | | | - Mary E Flowers
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Roger Herzig
- University of Louisville Hospital/James Brown Cancer Center, Louisville, Kentucky
| | | | | | | | - Thomas R Klumpp
- Temple Bone Marrow Transplant Program, Philadelphia, Pennsylvania
| | | | | | | | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | | | | | - John R Wingard
- Shands HealthCare and University of Florida, Gainesville, Florida
| | - Daniel J Weisdorf
- University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota
| | - Mary M Horowitz
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
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Pidala J, Lee SJ, Spellman SR, Wang H, Ahn KW, Aljurf MD, Askar M, Dehn J, Fernandez Viña MA, Gratwohl A, Gupta V, Hanna R, Hurley CK, Inamoto Y, Kassim AA, Nishihori T, Oudshoorn M, Petersdorf EW, Prasad VK, Saber W, Schultz KR, Wood WA, Storek J, Woolfrey AE, Anasetti C. HLA-Mismatch Is Associated with Worse Outcomes after Myeloablative Conditioning and Unrelated Donor Hematopoietic Cell Transplantation: A Cibmtr Analysis. Biol Blood Marrow Transplant 2014. [DOI: 10.1016/j.bbmt.2013.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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40
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Bodelon C, Malone KE, Johnson LG, Malkki M, Petersdorf EW, McKnight B, Madeleine MM. Common sequence variants in chemokine-related genes and risk of breast cancer in post-menopausal women. Int J Mol Epidemiol Genet 2013; 4:218-227. [PMID: 24319537 PMCID: PMC3852641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 11/03/2013] [Indexed: 06/03/2023]
Abstract
UNLABELLED Chemokines are small molecules that when secreted by tissues under pathological conditions such as inflammation are believed to be involved in carcinogenesis. Recent reports have found that the genetic variation in chemokine encoding genes are associated with risk of breast cancer. METHODS Using data from a population-based case-control study of 845 invasive breast cases and 807 controls, we genotyped 34 single nucleotide polymorphisms (SNPs) in 8 chemokine candidate genes (CCL3, CCL4, CCL5, CCL20, CCR5, CCR6, CXCL12 and CXCR4). Associations with breast cancer were computed for individual SNPs, groups of SNPs within genes, and in a gene-set analysis. We also performed a meta-analysis of CXCL12 rs1801157 and a haplotype analysis for two SNPs: CXCR4 rs2228014 and CXCL12 rs1801157. RESULTS We found no significant associations between the risk of breast cancer and any individual SNPs, single genes, or combined gene sets. Some individual variants were marginally associated with some histologic subtypes, but these associations were not significant after adjustment for multiple comparisons. In the meta-analysis of five studies of European ancestry, CXCL12 rs1801157 was marginally associated with breast cancer risk (OR=1.14, 95% CI: 1.00, 1.30). CONCLUSIONS Our findings suggest that genetic variants in the 8 candidate genes coding for chemotactic cytokines have little influence in the risk of breast cancer in postmenopausal women. Additional examination of the relationship between CXCL12 rs1801157 and breast cancer risk is warranted.
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Affiliation(s)
- Clara Bodelon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattle, WA, USA
- Current affiliation: Division of Cancer Epidemiology and Genetics, National Cancer InstituteBethesda, MD, USA
| | - Katheleen E Malone
- Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattle, WA, USA
- Department of Epidemiology, School of Public Health, University of WashingtonSeattle, WA, USA
| | - Lisa G Johnson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattle, WA, USA
| | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Research CenterSeattle, WA
| | - Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research CenterSeattle, WA
| | - Barbara McKnight
- Department of Biostatistics, School of Public Health, University of WashingtonSeattle, WA, USA
| | - Margaret M Madeleine
- Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattle, WA, USA
- Department of Epidemiology, School of Public Health, University of WashingtonSeattle, WA, USA
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Mendolia F, Klein JP, Petersdorf EW, Malkki M, Wang T. Comparison of statistics in association tests of genetic markers for survival outcomes. Stat Med 2013; 33:828-44. [PMID: 24105914 DOI: 10.1002/sim.5982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 08/21/2013] [Indexed: 11/07/2022]
Abstract
Computationally efficient statistical tests are needed in association testing of large scale genetic markers for survival outcomes. In this study, we explore several test statistics based on the Cox proportional hazards model for survival data. First, we consider the classical partial likelihood-based Wald and score tests. A revised way to compute the score statistics is explored to improve the computational efficiency. Next, we propose a Cox-Snell residual-based score test, which allows us to handle the controlling variables more conveniently. We also illustrated the incorporation of these three tests into a permutation procedure to adjust for the multiple testing. In addition, we examine a simulation-based approach proposed by Lin (2005) to adjust for multiple testing. We presented the comparison of these four statistics in terms of type I error, power, family-wise error rate, and computational efficiency under various scenarios via extensive simulation.
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Affiliation(s)
- Franco Mendolia
- Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, 53226, U.S.A
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42
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Bodelon C, Madeleine MM, Johnson LG, Du Q, Galloway DA, Malkki M, Petersdorf EW, Schwartz SM. Genetic variation in the TLR and NF-κB pathways and cervical and vulvar cancer risk: a population-based case-control study. Int J Cancer 2013; 134:437-44. [PMID: 23824834 DOI: 10.1002/ijc.28364] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 06/04/2013] [Accepted: 06/17/2013] [Indexed: 01/23/2023]
Abstract
Genital infection with the oncogenic human papillomavirus is the necessary cause of cervical cancer and of a large fraction of vulvar cancers. The toll-like receptor and the nuclear factor κB (NF-κB) signaling pathways have been implicated in inflammation, autoimmune disease and cancer, but whether common nucleotide variation in these pathways is associated with the risk of cervical and vulvar cancers has received little study. Using data from a population-based case-control study of cervical and vulvar cancers, we genotyped 205 single nucleotide polymorphisms (SNPs) in and around 32 candidate gene regions within these pathways. Gene-based analyses were used to estimate the associations between individual gene regions and the risk of cervical and vulvar cancers. Odds ratio (OR) and 95% confidence intervals (CI) were calculated to assess the risk of cervical and vulvar cancers for each SNP. p-Values were adjusted for multiple testing. A total of 876 cervical cancer cases, 517 vulvar cancer cases and 1,100 controls were included in the analysis. The TNF region was significantly associated with the risks of cervical cancer (gene-based p-value: 2.0 × 10(-4) ) and vulvar cancer (gene-based p-value: 1.0 × 10(-4) ). The rare allele (A) of SNP rs2239704 in the 5' UTR of the LTA gene was significantly associated with increased risks of cervical cancer (OR=1.31, 95% CI: 1.15-1.50; adjusted p-value: 0.013) and vulvar cancer (OR=1.51, 95% CI: 1.30-1.75; adjusted p-value: 1.9 × 10(-5) ). These findings add to the evidence of the importance of the immune system in the etiology of cervical and vulvar cancers.
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Affiliation(s)
- Clara Bodelon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
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Morishima Y, Kawase T, Malkki M, Morishima S, Spellman S, Kashiwase K, Kato S, Cesbron A, Tiercy JM, Senitzer D, Velardi A, Petersdorf EW. Significance of ethnicity in the risk of acute graft-versus-host disease and leukemia relapse after unrelated donor hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2013; 19:1197-203. [PMID: 23747601 DOI: 10.1016/j.bbmt.2013.05.020] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 05/29/2013] [Indexed: 12/16/2022]
Abstract
The significance of patient and donor ethnicity on risk of acute graft-versus-host disease (GVHD) and disease relapse after unrelated donor hematopoietic cell transplantation (HCT) is not known. A total of 4335 patient-donor pairs from the International Histocompatibility Working Group in HCT met the following 3 criteria: (1) HLA-A, -B, -C, -DRB1, and -DQB1 allele matched donor, (2) diagnosis of leukemia, and (3) non-T cell depleted GVHD prophylaxis. Posttransplantation risks of acute GVHD and leukemia relapse were defined in Asian/Pacific Islander, white, African American, Hispanic, and Native American patients that underwent transplantation from donors with the same self-described background. Asian patients had a significantly lower incidence of acute GVHD (Japanese patients: 40.0% grades II to IV and 15.3% grades III to IV; non-Japanese Asian patients: 42.1% grades II to IV and 15.7% grades III to IV) compared with white patients (56.5% grades II to IV and 22.6% grades III to IV) (P < .001). The hazard ratio of acute GVHD for white patients was significantly higher than for Japanese patients. Unexpectedly, the hazard ratio of leukemia relapse in white patients with early disease status was also significantly higher than that in Japanese patients. These results provide a platform for future investigation into the genetic factors for unrelated donor HCT and clinical implications of diverse ethnic background.
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Affiliation(s)
- Yasuo Morishima
- Japan Marrow Donor Program, Tokyo, Japan; Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
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Resler AJ, Malone KE, Johnson LG, Malkki M, Petersdorf EW, McKnight B, Madeleine MM. Genetic variation in TLR or NFkappaB pathways and the risk of breast cancer: a case-control study. BMC Cancer 2013; 13:219. [PMID: 23634849 PMCID: PMC3651307 DOI: 10.1186/1471-2407-13-219] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 04/25/2013] [Indexed: 01/01/2023] Open
Abstract
Background Toll-like receptors (TLRs) and the transcription factor nuclear factor-κB (NFκB) are important in inflammation and cancer. Methods We examined the association between breast cancer risk and 233 tagging single nucleotide polymorphisms within 31 candidate genes involved in TLR or NFκB pathways. This population-based study in the Seattle area included 845 invasive breast cancer cases, diagnosed between 1997 and 1999, and 807 controls aged 65–79. Results Variant alleles in four genes were associated with breast cancer risk based on gene-level tests: MAP3K1, MMP9, TANK, and TLR9. These results were similar when the risk of breast cancer was examined within ductal and luminal subtypes. Subsequent exploratory pathway analyses using the GRASS algorithm found no associations for genes in TLR or NFκB pathways. Using publicly available CGEMS GWAS data to validate significant findings (N = 1,145 cases, N = 1,142 controls), rs889312 near MAP3K1 was confirmed to be associated with breast cancer risk (P = 0.04, OR 1.15, 95% CI 1.01–1.30). Further, two SNPs in TANK that were significant in our data, rs17705608 (P = 0.05) and rs7309 (P = 0.04), had similar risk estimates in the CGEMS data (rs17705608 OR 0.83, 95% CI 0.72–0.96; CGEMS OR 0.90, 95% CI 0.80–1.01 and rs7309 OR 0.83, 95% CI 0.73–0.95; CGEMS OR 0.91, 95% CI 0.81–1.02). Conclusions Our findings suggest plausible associations between breast cancer risk and genes in TLR or NFκB pathways. Given the few suggestive associations in our data and the compelling biologic rationale for an association between genetic variation in these pathways and breast cancer risk, further studies are warranted that examine these effects.
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Affiliation(s)
- Alexa J Resler
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
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45
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Petersdorf EW, Malkki M, Horowitz MM, Spellman SR, Haagenson MD, Wang T. Mapping MHC haplotype effects in unrelated donor hematopoietic cell transplantation. Blood 2013; 121:1896-905. [PMID: 23305741 PMCID: PMC3591807 DOI: 10.1182/blood-2012-11-465161] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 12/21/2012] [Indexed: 01/09/2023] Open
Abstract
Life-threatening risks associated with HLA-mismatched unrelated donor hematopoietic cell transplantation limit its general application for the treatment of blood diseases. The increased risks might be explained by undetected genetic variation within the highly polymorphic major histocompatibility complex (MHC) region. We retrospectively assessed each of 1108 MHC region single nucleotide polymorphisms (SNPs) in 2628 patients and their HLA-mismatched unrelated donors to determine whether SNPs are associated with the risk of mortality, disease-free survival, transplant-related mortality, relapse, and acute and chronic graft-versus-host disease (GVHD). Multivariate analysis adjusted for HLA mismatching and nongenetic variables associated with each clinical end point. Twelve SNPs were identified as transplantation determinants. SNP-associated risks were conferred by either patient or donor SNP genotype or by patient-donor SNP mismatching. Risks after transplantation increased with increasing numbers of unfavorable SNPs. SNPs that influenced acute GVHD were independent of those that affected risk of chronic GVHD and relapse. HLA haplotypes differed with respect to haplotype content of (un)favorable SNPs. Outcome after HLA-mismatched unrelated donor transplantation is influenced by MHC region variation that is undetected with conventional HLA typing. Knowledge of the SNP content of HLA haplotypes provides a means to estimate risks prior to transplantation and to lower complications through judicious selection of donors with favorable MHC genetics.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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46
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Hussain SK, Madeleine MM, Johnson LG, Du Q, Galloway DA, Daling JR, Malkki M, Petersdorf EW, Schwartz SM. Nucleotide variation in IL-10 and IL-12 and their receptors and cervical and vulvar cancer risk: a hybrid case-parent triad and case-control study. Int J Cancer 2013; 133:201-13. [PMID: 23280621 DOI: 10.1002/ijc.28000] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 11/08/2012] [Accepted: 12/03/2012] [Indexed: 11/11/2022]
Abstract
Given the important role of cell mediated immunity in viral clearance and control of premalignant lesions, we hypothesize that variation in the IL-12/IL-10 cytokine and cytokine receptor genes may influence cervical and vulvar cancer risk. We evaluated 76 tagSNPs from seven candidate genes (IL-10, IL-12A, IL-12B, IL-10RA, IL-10RB, IL-12RB1, and IL12RB2) in case-parent sets (n=43 cervical squamous cell carcinoma (SCC), n=96 cervical adenocarcinoma, n=53 vulvar SCC), additional cases (n=356 cervical SCC, n=406 cervical adenocarcinoma, and n=473 vulvar SCC) and population based controls (1,111). We calculated log-additive odds ratios (ORs) and 95% confidence intervals (CIs) for the association between tagSNP and cancer risk using a pseudo-likelihood based method which combined genotype information on cases, parents, and population controls. After correction for multiple comparisons, we identified several statistically significant SNP associations. Cervical SCC risk was associated with the minor alleles of the IL10RA rs9610 3' UTR SNP (OR=1.76, 95% CI=1.15-2.68) and two synonymous IL12RB2 SNPs (rs4297265, OR=0.46, 95% CI=0.26-0.82; rs2229546, OR=0.43, 95% CI=0.21-0.87). Cervical adenocarcinoma risk was associated with the minor alleles of the IL10RA rs4252314 intronic SNP (OR=2.23, 95% CI=1.26-3.96) and IL12RB1 rs11575934 non-synonymous SNP (OR=1.51, 95% CI=1.12-2.05). Finally, the minor allele of the IL12B rs3181224 3' UTR SNP was associated with a reduced risk of vulvar SCC (OR=0.30, 95% CI=0.12-0.74). These results raise the possibility that a shift in the balance of the immune response due to genetic variants in key cytokine genes could influence the development of cervical and vulvar cancer.
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Affiliation(s)
- Shehnaz K Hussain
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
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47
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Petersdorf EW, Malkki M, Hsu K, Bardy P, Cesbron A, Dickinson A, Dubois V, Fleischhauer K, Kawase T, Madrigal A, Morishima Y, Shaw B, Spellman S, Spierings E, Stern M, Tiercy JM, Velardi A, Gooley T. 16th IHIW: international histocompatibility working group in hematopoietic cell transplantation. Int J Immunogenet 2012; 40:2-10. [PMID: 23279968 DOI: 10.1111/iji.12022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 10/22/2012] [Accepted: 10/23/2012] [Indexed: 11/28/2022]
Abstract
The International Histocompatibility Working Group is a collaborative international effort to understand the HLA and non-HLA genetics of the transplantation barrier. The Working Group is comprised of experts in the fields of histocompatibility and immunogenetics, hematopoietic cell transplantation and outcomes research. Data for 25 855 unrelated donor transplants were submitted in support of research studies for the 16th International Histocompatibility Workshop. Active investigation is in progress in seven key areas: the impact of HLA matching, role of race and ethnicity, identification of permissible HLA mismatches, haplotype-associated determinants, minor histocompatibility antigens, immune response genes and KIR genetics. New hypotheses for the 16th workshop were developed for immunogenetic studies in cord blood and haploidentical-related donor transplantation.
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Affiliation(s)
- E W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Petersdorf EW, Malkki M, Gooley TA, Spellman SR, Haagenson MD, Horowitz MM, Wang T. MHC-resident variation affects risks after unrelated donor hematopoietic cell transplantation. Sci Transl Med 2012; 4:144ra101. [PMID: 22837536 DOI: 10.1126/scitranslmed.3003974] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Blood malignancies can be cured with hematopoietic cell transplantation from human leukocyte antigen (HLA)-matched unrelated donors; however, acute graft-versus-host disease (GVHD) affects up to 80% of patients and contributes to increased mortality. To test the hypothesis that undetected patient-donor differences for non-HLA genetic variation within the major histocompatibility complex (MHC) could confer risks after HLA-matched transplantation, we conducted a discovery-validation study of 4205 transplants for 1120 MHC region single-nucleotide polymorphisms (SNPs). Two SNPs were identified as markers for disease-free survival and acute GVHD. Among patients with two or more HLA-matched unrelated donors identified on their search, SNP genotyping of patients and their potential donors demonstrated that most patients have a choice of SNP-matched donors. In conclusion, the success of HLA-matched unrelated donor hematopoietic cell transplantation depends on non-HLA MHC region genetic variation. Prospective SNP screening and matching provides an approach for lowering risks to patients.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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Bodelon C, Madeleine MM, Johnson LG, Du Q, Malkki M, Petersdorf EW, Schwartz SM. Genetic variation in CD83 and risks of cervical and vulvar cancers: a population-based case-control study. Gynecol Oncol 2012; 124:525-8. [PMID: 22134374 PMCID: PMC3727898 DOI: 10.1016/j.ygyno.2011.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 11/10/2011] [Accepted: 11/14/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES The CD83 glycoprotein is a marker of dendritic cell maturation that may contribute to the T cell response to oncogenic human papillomavirus (HPV) infection. Whether single nucleotide polymorphisms (SNPs) in CD83 influence the risk of HPV-related genital cancers has not been adequately studied. We investigated whether the common genetic variation of the CD83 region was associated with the risks of cervical and vulvar cancers in a population-based case-control study conducted in the Seattle-Puget Sound Region. METHODS A total of 17 tagSNPs were genotyped in the CD83 region of 886 cervical cases, 517 vulvar cases and 1100 controls. Odds ratio (OR) and 95% confidence intervals (CI) were computed to assess the risk of cervical and vulvar cancers. The interaction between the tagSNPs and cigarette smoking was also explored. RESULTS TagSNPs in the CD83 chromosomal region were not associated with risk of either cervical or vulvar cancer. TagSNP rs853360 was associated with a decreased risk of cervical squamous cell carcinoma (SCC) (OR=0.80; 95% CI: 0.66-0.98). CONCLUSIONS Our results do not suggest that the common genetic variation of CD83 is related to cervical or vulvar cancers. The association between tagSNP rs853360 and risk of cervical SCC is likely to be due to chance. If larger or pooled studies confirm our results, CD83 has little or no influence in the risk of HPV-related cancers.
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Affiliation(s)
- Clara Bodelon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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Fleischhauer K, Shaw BE, Gooley T, Malkki M, Bardy P, Bignon JD, Dubois V, Horowitz MM, Madrigal JA, Morishima Y, Oudshoorn M, Ringden O, Spellman S, Velardi A, Zino E, Petersdorf EW. Effect of T-cell-epitope matching at HLA-DPB1 in recipients of unrelated-donor haemopoietic-cell transplantation: a retrospective study. Lancet Oncol 2012; 13:366-74. [PMID: 22340965 DOI: 10.1016/s1470-2045(12)70004-9] [Citation(s) in RCA: 244] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The risks after unrelated-donor haemopoietic-cell transplantation with matched HLA-A, HLA-B, HLA-C, HLA-DRB1, HLA-DQB1 alleles between donor and recipient (10/10 matched) can be decreased by selection of unrelated donors who also match for HLA-DPB1; however, such donors are difficult to find. Classification of HLA-DPB1 mismatches based on T-cell-epitope groups could identify mismatches that might be tolerated (permissive) and those that would increase risks (non-permissive) after transplantation. We did a retrospective study to compare outcomes between permissive and non-permissive HLA-DPB1 mismatches in unrelated-donor haemopoietic-cell transplantation. METHODS HLA and clinical data for unrelated-donor [corrected] transplantations submitted to the International Histocompatibility Working Group in haemopoietic-cell transplantation were analysed retrospectively. HLA-DPB1 T-cell-epitope groups were assigned according to a functional algorithm based on alloreactive T-cell crossreactivity patterns. Recipients and unrelated donors matching status were classified as HLA-DPB1 match, non-permissive HLA-DPB1 mismatch (those with mismatched T-cell-epitope groups), or permissive HLA-DPB1 mismatch (those with matched T-cell-epitope groups). The clinical outcomes assessed were overall mortality, non-relapse mortality, relapse, and severe (grade 3-4) acute graft-versus-host disease (aGvHD). FINDINGS Of 8539 transplantations, 5428 (64%) were matched for ten of ten HLA alleles (HLA 10/10 matched) and 3111 (36%) for nine of ten alleles (HLA 9/10 matched). Of the group overall, 1719 (20%) were HLA-DPB1 matches, 2670 (31%) non-permissive HLA-DPB1 mismatches, and 4150 (49%) permissive HLA-DPB1 mismatches. In HLA 10/10-matched transplantations, non-permissive mismatches were associated with a significantly increased risk of overall mortality (hazard ratio [HR] 1·15, 95% CI 1·05-1·25; p=0·002), non-relapse mortality (1·28, 1·14-1·42; p<0·0001), and severe aGvHD (odds ratio [OR] 1·31, 95% CI 1·11-1·54; p=0·001), but not relapse (HR 0·89, 95% CI 0·77-1·02; p=0·10), compared with permissive mismatches. There were significant differences between permissive HLA-DPB1 mismatches and HLA-DPB1 matches in terms of non-relapse mortality (0·86, 0·75-0·98; p=0·03) and relapse (1·34, 1·17-1·54; p<0·0001), but not for overall mortality (0·96, 0·87-1·06; p=0·40) or aGvHD (OR 0·84, 95% CI 0·69-1·03; p=0·09). In the HLA 9/10 matched population, non-permissive HLA-DPB1 mismatches also increased the risk of overall mortality (HR 1·10, 95% CI 1·00-1·22; p=0·06), non-relapse mortality (1·19, 1·05-1·36; p=0·007), and severe aGvHD (OR 1·37, 95% CI 1·13-1·66; p=0·002) compared with permissive mismatches, but the risk of relapse was the same in both groups (HR 0·93, 95% CI 0·78-1·11; p=0·44). Outcomes for HLA 10/10-matched transplantations with non-permissive HLA-DPB1 mismatches did not differ substantially from those for HLA 9/10-matched transplantations with permissive HLA-DPB1 mismatches or HLA-DPB1 matches. INTERPRETATION T-cell-epitope matching defines permissive and non-permissive HLA-DPB1 mismatches. Avoidance of an unrelated donor with a non-permissive T-cell-epitope mismatch at HLA-DPB1 might provide a practical clinical strategy for lowering the risks of mortality after unrelated-donor haemopoietic-cell transplantation. FUNDING National Institutes of Health; Associazione Italiana per la Ricerca sul Cancro; Telethon Foundation; Italian Ministry of Health; Cariplo Foundation; National Cancer Institute; National Heart, Lung and Blood Institute; National Institute of Allergy and Infectious Diseases; Office of Naval Research; IRGHET Paris; Swedish Cancer Society; Children's Cancer Foundation; Swedish Research Council; Cancer Society in Stockholm; Karolinska Institutet; and Leukemia and Lymphoma Society.
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Affiliation(s)
- Katharina Fleischhauer
- Unit of Molecular and Functional Immunogenetics, Division of Regenerative Medicine, Stem Cells and Gene Therapy, Istituto di Ricovero e Cura a Carattere Scientifico H San Raffaele, Milan, Italy
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