Sex-specific survival difference in association with HLA-DRB1∗04 following allogeneic haematopoietic stem cell transplantation for lymphoid malignancies

Katalin Balassa, Hajnalka Andrikovics, Peter Remenyi, Arpad Batai, Aniko Szilvasi, Andras Bors, Katalin Piroska Kiss, Katalin Rajczy, Dora Inotai, Eva Torbagyi, Lilla Lengyel, Aniko Barta, Laszlo Gopcsa, Attila Tordai, Tamas Masszi

Research output: Contribution to journalArticle

Abstract

The role of HLA system in allogeneic haematopoietic stem cell transplantation (allo-HSCT) outcome is unarguable. In this study we investigated association of HLA-A,-B and-DRB1 alleles with overall survival (OS) in 186 patients undergoing allo-HSCT for lymphoid malignancies. Analyses confirmed significantly better OS for HLA-DRB1∗04 carriers compared with non-carriers (p = 0.01). Survival benefit was confined to male patients (in multivariate analyses p = 0.034, hazard ratio 0.35, 95% confidence interval 0.13–0.92), whereas in females no difference was noted (p = 0.82). Furthermore, donor gender also affected outcome and transplantation from female HLA-DRB1∗04 carrier donors resulted in superior survival compared with female non-carrier donors (p = 0.01). Combined analyses including recipient/donor gender and HLA-DRB1∗04 showed that survival of male patients varied significantly according to donor gender and HLA-DRB1∗04 carriership (p = 0.04) with best survival among HLA-DRB1∗04 carriers transplanted from female donors. Of relevance to our results, HLA-DRB1∗04 has been documented as risk allele group for lymphoid malignancies, and studies described a male-specific risk. We believe that our findings provide further supporting evidence for sex-specific alterations secondary to HLA-DRB1∗04 or related genes. Further studies are warranted to evaluate whether in contrast to general favour of male donors HLA-DRB1∗04 carrier patients with lymphoid malignancies could benefit from transplantation from female donors.

Original languageEnglish
Pages (from-to)13-19
Number of pages7
JournalHuman Immunology
Volume79
Issue number1
DOIs
Publication statusPublished - Jan 2018

Keywords

  • Allogeneic HSCT
  • HLA allele groups
  • HLA-DRB1∗04
  • Lymphoid malignancy
  • Survival

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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