aGVHD In Hematopoietic Stem Cell Transplantation Research Articles

Effect of major histocompatibility complex haplotype matching by C4 and MICA genotyping on acute graft versus host disease in unrelated hematopoietic stem cell transplantation

We explored whether matching of human leukocyte antigen (HLA) haplotypes between the recipient and donor of hematopoietic stem cell transplantation (HSCT) predicted by C4 and MICA typing is associated with the incidence of acute graft versus host disease (aGVHD). DNA preparations collected from a total of 81 recipient and donor pairs were used for PCR-based C4 subtyping and/or MICA sequence-based typing. Incidences of aGVHD were compared according to C4 and MICA matching. The six most common MICA alleles were MICA*008:01, *010:01, *002:01, *004, *009:01/049, and *012:01. Among the 59 unrelated pairs, HLA alleles were matched in 34 (57.6%). C4 subtypes were identical between the recipient and donor in 28 (82.4%) HLA-matched unrelated pairs, while MICA genotypes were matched in all HLA-matched unrelated pairs. In the 22 HLA-matched related pairs, all recipients showed identical C4 subtypes with their respective donors. In multivariate analysis, C4 mismatch was a significant risk factor associated with the development of aGVHD in unrelated HSCT (hazard ratio=3.24, P=0.006). PCR-based C4 subtyping is a simple method for assessing the genetic identity of the HLA region between a recipient and unrelated donor. This test would be also useful for prediction of aGVHD in HSCT.

IL-10 promoter polymorphism associated with decreased risk of aGvHD after stem cell transplantation: a meta-analysis

The bulk of evidences indicates that variations in the coding for cytokines or the regulation of their expression may play a role in acute graft-versus-host disease (aGvHD) following allogeneic hematopoietic stem cell transplantation (HSCT). It is unclear whether IL-10 promoter polymorphism is associated with the occurrence of aGvHD in allogeneic HSCT. A systematic search was performed in PubMed and Embase databases and 10 studies were identified for inclusion. Data were extracted and pooled ORs together with 95% CIs were calculated. The pooled result indicated that -592A allele in recipient was significantly associated with reduced risk of moderate aGvHD in HSCT [OR = 0.41 (0.21, 0.79), P = 0.008, I² = 25%]. The same pattern was also obtained from the -819T allele in recipient [OR = 0.38 (0.18, 0.79), P = 0.01, I² = 41%]. Furthermore, we found a significant positive correlation between the -592AA homozygote and lower risk of severe aGvHD in HSCT [OR = 0.54 (0.34, 0.86), P = 0.01, I² = 29%]. The similar result was gained from the -1082A allele in recipient and decreased risk of severe aGvHD [OR = 0.71 (0.52, 0.98), P = 0.04, I² = 19%]. However, there was no significant association between -592A, -819T, or -1082A allele in donor and risk of aGvHD. This meta-analysis suggests that the IL-10 A allele or AA homozygote at -592, T allele at -819 and the A allele at -1082 are associated with reduced risk of aGvHD in allogeneic HSCT.