Abstract
Aim Genetic recombination occurs at specific hotspots within the MHC, leading to widely dispersed block-like structures; the alpha block containing HLA-A, beta block (HLA-C and HLA-B) and delta block (HLA-DR and HLA-DQ). Linkage disequilibrium (LD) is much stronger within than across these blocks. The HLA-A locus (most telomeric) has weaker LD with extended HLA haplotypes. Additionally, a recombination hotspot exists between HLA-DP genes and other class II loci, which leads to an HLA-DPB1 match rate of only 10–15% in 10/10 HLA-matched donor/recipient pairs. This report describes an extended 9 locus HLA haplotype found in 2 HCT and 1 kidney transplant recipients and their potential donors (8, 2 and 1 donors, respectively). Methods 1. Case review of 2 unrelated HCT recipients, both European Caucasian (CAU) and their related and unrelated potential donors. 2. Family study of HCT recipient and a sibling to identify the haplotype by segregation. 3. Determine frequency of observed haplotype in different populations through Haplostats.org (6 locus at 2 field resolution could yield higher estimate than the 9 locus 3 field resolution haplotype described here). 4. Searching lab database for incidence of this haplotype. Results All identified cases shared the following haplotype HLA-A*31:01:02∼C*07:02:01∼B*07:02:01∼DRB5*01:01:01∼DRB1*15:01:01∼DQA1*01:02:01∼DQB1*06:02:01∼DPA1*01:03:01∼DPB1*04:01:01. Although most alleles in this haplotype are fairly common, with HLA-A*31:01 least common (∼5%), Haplostats indicated that the haplotype HLA-A*31:01∼C*07:02∼B*07:02∼DRB5*01:01∼DRB1*15:01∼DQB1*06:02 ranks 61898th & 170477th in CAU & African Americans (AFA), respectively and is not seen in other populations. Searching our laboratory database for subjects A31 positive, 382 subjects out of 8340 typed between 2015 & 2017 were identified. Of those, 40 were positive for the haplotype HLA-A*31:01∼C*07:02∼B*07:02∼DRB5*01:01∼DRB1*15:01∼DQB1*06:02 and of these 17 were typed for HLA-DPB1. All were positive for the entire extended 9 locus haplotype and were either CAU (n = 6) or of unknown ethnicity (n = 11). Conclusions Although the 6 locus haplotype portion of this extended haplotype seems fairly uncommon, the extended 9 locus subset of that haplotype seems to be conserved especially in Caucasians.
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