HLA-DRB1*04 CONFERS BETTER OVERALL SURVIVAL TO MALE PATIENTS WITH LYMPHOID MALIGNANCIES FOLLOWING ALLOGENEIC HAEMATOPOIETIC STEM CELL TRANSPLANTATION
(Abstract release date: 05/19/16)
EHA Library. Balassa K. 06/09/16; 133047; E1498
Dr. Katalin Balassa
Contributions
Contributions
Abstract
Abstract: E1498
Type: Eposter Presentation
Background
Several studies reported associations of individual human leukocyte antigen (HLA) genes and outcome of allogeneic haematopoietic stem cell transplantation (allo-HSCT). Similarly, HLA genes were found to predispose to certain lymphoid malignancies. HLA-DRB1*04 is among the documented genetic risk factors for lymphoid malignancies, and in some studies the risk was identified to be male-restricted.
Aims
In this study we looked into the effect of HLA-A, -B and -DRB1 allele groups on overall survival (OS) following allo-HSCT in patients with lymphoid malignancies.
Methods
Data of 186 consecutive adult patients, who underwent first allo-HSCT for a lymphoid malignancy at our single centre in Hungary between 2007 and 2013, were retrospectively analysed. The median follow-up time for surviving patients was 44 months. In the cohort five patients (3%) received a graft, mismatched for HLA-A, and none for HLA-B or HLA-DRB1 at the antigen level. There were slightly more patients undergoing transplantation from a sibling donor (106/186, 57%).
Results
Examining the role of HLA status on survival, analyses showed that carriers and non-carriers displayed no survival difference for any of the HLA-A or -B allele groups. However, OS of HLA-DRB1*04 carriers was significantly better compared with non-carriers (24-month OS 66±8% [n= 36] vs. 50±4% [n=150], p=0.01). As baseline transplantation characteristics were uneven in the two groups, we conducted multivariate analyses, which showed that the association remained independent (p=0.05, odds ratio [OR] 0.55, 95% confidence interval [CI]: 0.3-1).In view of previous reports of sex-specific features of HLA-DRB1*04, we performed separate analyses for male (n=114) and female (n=72) patients. Interestingly, the survival benefit was confined to males (p=0.01), whereas in female individuals no difference was detected (p=0.41). The baseline transplantation characteristics were comparable in female and male patients. Furthermore, we found that the donor gender also affected the outcome. The survival of male patients varied significantly according to recipient/donor gender pairs and HLA-DRB1*04 carriership (p=0.04). Surprisingly, in male recipients the best survival was achieved in HLA-DRB1*04 carriers who received a graft from a female donor, followed by those HLA-DRB1*04 carriers for whom the donor was male. HLA-DRB1*04 negative patients displayed worse survival compared with carriers, and among them the survival was worse for those whose donor was female. No clear explanation was found to explain the survival benefit, although there was a tendency for less CMV reactivation/disease among HLA-DRB1*04 carriers (3/36, 8% vs. 31/150, 21%, p=0.097).
Conclusion
In summary, we observed in a cohort of 186 patients with lymphoid malignancies that HLA-DRB1*04 male carriers had significantly better overall survival following allo-HSCT compared to non-carriers. Our findings support that HLA-DRB1*04 carriership might result in male-specific consequences in the lymphoid malignancy patient group. Our results suggest that the prognosis of patients with sex-specific disease risks might be modified by transplantation from the opposite sex. Our findings should be confirmed in larger patient populations, and similar data could affect donor selection preferences for HLA-DRB1*04 carrier patients in the future.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, HLA, Lymphoid malignancy, Survival
Type: Eposter Presentation
Background
Several studies reported associations of individual human leukocyte antigen (HLA) genes and outcome of allogeneic haematopoietic stem cell transplantation (allo-HSCT). Similarly, HLA genes were found to predispose to certain lymphoid malignancies. HLA-DRB1*04 is among the documented genetic risk factors for lymphoid malignancies, and in some studies the risk was identified to be male-restricted.
Aims
In this study we looked into the effect of HLA-A, -B and -DRB1 allele groups on overall survival (OS) following allo-HSCT in patients with lymphoid malignancies.
Methods
Data of 186 consecutive adult patients, who underwent first allo-HSCT for a lymphoid malignancy at our single centre in Hungary between 2007 and 2013, were retrospectively analysed. The median follow-up time for surviving patients was 44 months. In the cohort five patients (3%) received a graft, mismatched for HLA-A, and none for HLA-B or HLA-DRB1 at the antigen level. There were slightly more patients undergoing transplantation from a sibling donor (106/186, 57%).
Results
Examining the role of HLA status on survival, analyses showed that carriers and non-carriers displayed no survival difference for any of the HLA-A or -B allele groups. However, OS of HLA-DRB1*04 carriers was significantly better compared with non-carriers (24-month OS 66±8% [n= 36] vs. 50±4% [n=150], p=0.01). As baseline transplantation characteristics were uneven in the two groups, we conducted multivariate analyses, which showed that the association remained independent (p=0.05, odds ratio [OR] 0.55, 95% confidence interval [CI]: 0.3-1).In view of previous reports of sex-specific features of HLA-DRB1*04, we performed separate analyses for male (n=114) and female (n=72) patients. Interestingly, the survival benefit was confined to males (p=0.01), whereas in female individuals no difference was detected (p=0.41). The baseline transplantation characteristics were comparable in female and male patients. Furthermore, we found that the donor gender also affected the outcome. The survival of male patients varied significantly according to recipient/donor gender pairs and HLA-DRB1*04 carriership (p=0.04). Surprisingly, in male recipients the best survival was achieved in HLA-DRB1*04 carriers who received a graft from a female donor, followed by those HLA-DRB1*04 carriers for whom the donor was male. HLA-DRB1*04 negative patients displayed worse survival compared with carriers, and among them the survival was worse for those whose donor was female. No clear explanation was found to explain the survival benefit, although there was a tendency for less CMV reactivation/disease among HLA-DRB1*04 carriers (3/36, 8% vs. 31/150, 21%, p=0.097).
Conclusion
In summary, we observed in a cohort of 186 patients with lymphoid malignancies that HLA-DRB1*04 male carriers had significantly better overall survival following allo-HSCT compared to non-carriers. Our findings support that HLA-DRB1*04 carriership might result in male-specific consequences in the lymphoid malignancy patient group. Our results suggest that the prognosis of patients with sex-specific disease risks might be modified by transplantation from the opposite sex. Our findings should be confirmed in larger patient populations, and similar data could affect donor selection preferences for HLA-DRB1*04 carrier patients in the future.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, HLA, Lymphoid malignancy, Survival
Abstract: E1498
Type: Eposter Presentation
Background
Several studies reported associations of individual human leukocyte antigen (HLA) genes and outcome of allogeneic haematopoietic stem cell transplantation (allo-HSCT). Similarly, HLA genes were found to predispose to certain lymphoid malignancies. HLA-DRB1*04 is among the documented genetic risk factors for lymphoid malignancies, and in some studies the risk was identified to be male-restricted.
Aims
In this study we looked into the effect of HLA-A, -B and -DRB1 allele groups on overall survival (OS) following allo-HSCT in patients with lymphoid malignancies.
Methods
Data of 186 consecutive adult patients, who underwent first allo-HSCT for a lymphoid malignancy at our single centre in Hungary between 2007 and 2013, were retrospectively analysed. The median follow-up time for surviving patients was 44 months. In the cohort five patients (3%) received a graft, mismatched for HLA-A, and none for HLA-B or HLA-DRB1 at the antigen level. There were slightly more patients undergoing transplantation from a sibling donor (106/186, 57%).
Results
Examining the role of HLA status on survival, analyses showed that carriers and non-carriers displayed no survival difference for any of the HLA-A or -B allele groups. However, OS of HLA-DRB1*04 carriers was significantly better compared with non-carriers (24-month OS 66±8% [n= 36] vs. 50±4% [n=150], p=0.01). As baseline transplantation characteristics were uneven in the two groups, we conducted multivariate analyses, which showed that the association remained independent (p=0.05, odds ratio [OR] 0.55, 95% confidence interval [CI]: 0.3-1).In view of previous reports of sex-specific features of HLA-DRB1*04, we performed separate analyses for male (n=114) and female (n=72) patients. Interestingly, the survival benefit was confined to males (p=0.01), whereas in female individuals no difference was detected (p=0.41). The baseline transplantation characteristics were comparable in female and male patients. Furthermore, we found that the donor gender also affected the outcome. The survival of male patients varied significantly according to recipient/donor gender pairs and HLA-DRB1*04 carriership (p=0.04). Surprisingly, in male recipients the best survival was achieved in HLA-DRB1*04 carriers who received a graft from a female donor, followed by those HLA-DRB1*04 carriers for whom the donor was male. HLA-DRB1*04 negative patients displayed worse survival compared with carriers, and among them the survival was worse for those whose donor was female. No clear explanation was found to explain the survival benefit, although there was a tendency for less CMV reactivation/disease among HLA-DRB1*04 carriers (3/36, 8% vs. 31/150, 21%, p=0.097).
Conclusion
In summary, we observed in a cohort of 186 patients with lymphoid malignancies that HLA-DRB1*04 male carriers had significantly better overall survival following allo-HSCT compared to non-carriers. Our findings support that HLA-DRB1*04 carriership might result in male-specific consequences in the lymphoid malignancy patient group. Our results suggest that the prognosis of patients with sex-specific disease risks might be modified by transplantation from the opposite sex. Our findings should be confirmed in larger patient populations, and similar data could affect donor selection preferences for HLA-DRB1*04 carrier patients in the future.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, HLA, Lymphoid malignancy, Survival
Type: Eposter Presentation
Background
Several studies reported associations of individual human leukocyte antigen (HLA) genes and outcome of allogeneic haematopoietic stem cell transplantation (allo-HSCT). Similarly, HLA genes were found to predispose to certain lymphoid malignancies. HLA-DRB1*04 is among the documented genetic risk factors for lymphoid malignancies, and in some studies the risk was identified to be male-restricted.
Aims
In this study we looked into the effect of HLA-A, -B and -DRB1 allele groups on overall survival (OS) following allo-HSCT in patients with lymphoid malignancies.
Methods
Data of 186 consecutive adult patients, who underwent first allo-HSCT for a lymphoid malignancy at our single centre in Hungary between 2007 and 2013, were retrospectively analysed. The median follow-up time for surviving patients was 44 months. In the cohort five patients (3%) received a graft, mismatched for HLA-A, and none for HLA-B or HLA-DRB1 at the antigen level. There were slightly more patients undergoing transplantation from a sibling donor (106/186, 57%).
Results
Examining the role of HLA status on survival, analyses showed that carriers and non-carriers displayed no survival difference for any of the HLA-A or -B allele groups. However, OS of HLA-DRB1*04 carriers was significantly better compared with non-carriers (24-month OS 66±8% [n= 36] vs. 50±4% [n=150], p=0.01). As baseline transplantation characteristics were uneven in the two groups, we conducted multivariate analyses, which showed that the association remained independent (p=0.05, odds ratio [OR] 0.55, 95% confidence interval [CI]: 0.3-1).In view of previous reports of sex-specific features of HLA-DRB1*04, we performed separate analyses for male (n=114) and female (n=72) patients. Interestingly, the survival benefit was confined to males (p=0.01), whereas in female individuals no difference was detected (p=0.41). The baseline transplantation characteristics were comparable in female and male patients. Furthermore, we found that the donor gender also affected the outcome. The survival of male patients varied significantly according to recipient/donor gender pairs and HLA-DRB1*04 carriership (p=0.04). Surprisingly, in male recipients the best survival was achieved in HLA-DRB1*04 carriers who received a graft from a female donor, followed by those HLA-DRB1*04 carriers for whom the donor was male. HLA-DRB1*04 negative patients displayed worse survival compared with carriers, and among them the survival was worse for those whose donor was female. No clear explanation was found to explain the survival benefit, although there was a tendency for less CMV reactivation/disease among HLA-DRB1*04 carriers (3/36, 8% vs. 31/150, 21%, p=0.097).
Conclusion
In summary, we observed in a cohort of 186 patients with lymphoid malignancies that HLA-DRB1*04 male carriers had significantly better overall survival following allo-HSCT compared to non-carriers. Our findings support that HLA-DRB1*04 carriership might result in male-specific consequences in the lymphoid malignancy patient group. Our results suggest that the prognosis of patients with sex-specific disease risks might be modified by transplantation from the opposite sex. Our findings should be confirmed in larger patient populations, and similar data could affect donor selection preferences for HLA-DRB1*04 carrier patients in the future.
Session topic: E-poster
Keyword(s): Allogeneic hematopoietic stem cell transplant, HLA, Lymphoid malignancy, Survival
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