P062 Evaluation of HLA-DP T-cell epitope (TCE) matching algorithm for selecting donors BMT/HSCT

Autor: Ina Skaljic, Sylvia Piggott, Gopal Patel, Anish Laul, Siva Kanangat
Rok vydání: 2016
Předmět:
Zdroj: Human Immunology. 77:83
ISSN: 0198-8859
DOI: 10.1016/j.humimm.2016.07.127
Popis: Objective To determine the clinical validity of determining permissible or non-permissible HLA-DP Mismatch in the graft vs host direction and host vs graft direction for DP Mismatched BMT/HSCT. Methods The HLA-DP permissiveness is based on the TCE (T cell epitope) into 3 groups based on their immunogenicity or the cross reactivity of T cells allo-reactive to the HLA-DP allele as to: highly immunogenic; moderately immunogenic; and low immunogenicity [DPB1 T-Cell Epitope Algorithm v2.0 (2015–04)]. A retrospective study of 31 patients who underwent BMT/HSCT from a related or unrelated donor with whom they had a DP mismatch was done. High resolution typing by Sequence based typing was used to determine the DP alleles of the recipient and donor. The data was compiled and using the algorithm, the expected outcome was determined. The expected outcome was then compared with the clinical outcome. The results were analyzed under the following potential outcomes- transplant related mortality, GVHD, HVGD and relapse. Results Out of the 31 patients studied, the algorithm classified 15 pairs to be permissive (DP-P) and 16 non permissive (DP-NP). In the DP-NP transplants, 9 out of 16 patients were expected to develop aGVHD and 7/16 was expected to develop HVGD. In reality, 2 died due to TRM. Of the remaining 14, 6 developed GVHD and 6 developed HVHD, and 2 (15%) had relapse. In the DP-P transplants, the expected outcome was 0% TRM, 0%GVHD and, 0% HVGD. However, 2/15 (13%) died due to TRM, 7/13 (54%) developed aGVHD, 2/13 (15%) developed an HVGD with an average engraftment of 91%. The severity of aGVHD was less compared to what was observed in Non-Permissive mismatch. Among the 13 patients, 8 (61%) had relapse. Conclusions With this very limited analysis, it appears that the DP Mismatch Algorithm based on TCE seems to hold true regarding DP-NP mismatch. The DP-P mismatches had high relapse, and less severe aGVHD compared to DP-NP. The algorithm is worth exploring and we need more multi center retrospective and prospective evaluations. Ref.: Crivello P, et al. Transplantation Biol Blood Marrow Transplant (2015) 21:233–41.
Databáze: OpenAIRE
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