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 Blood, 1 October 2009, Vol. 114, No. 14, pp. 2884-2887.
Prepublished online as a Blood First Edition Paper on August 4, 2009; DOI 10.1182/blood-2009-05-223172.

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CLINICAL TRIALS AND OBSERVATIONS

Brief Report

Donor-recipient mismatches in MHC class I chain-related gene A in unrelated donor transplantation lead to increased incidence of acute graft-versus-host disease

Simrit Parmar1,*, Marcos del Lima1, Yizhou Zou2,*, Poliana A. Patah3, Ping Liu1, Pedro Cano1, Gabriela Rondon1, Susana Pesoa1, Leandro de Padua Silva1, Muzaffar H. Qazilbash1, Chitra Hosing1, Uday Popat1, Partow Kebriaei1, Elizabeth J. Shpall1, Sergio Giralt1, Richard E. Champlin1, Peter Stastny2,{dagger}, and Marcelo Fernandez-Vina1,{dagger}

1 Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M. D. Anderson Cancer Center, Houston; 2 University of Texas Southwestern Medical Center, Dallas; and 3 Hospital Sirio Libanes, Hematology Service, Sao Paulo, Brazil

The polymorphic products of major histocompatibility complex class I–related chain A (MICA) genes are important in solid organ transplantation rejection. MICA expression is limited to gut epithelium and may play a role in triggering acute graft-versus-host disease (aGVHD). A total of 236 recipients of unrelated donor transplantation were studied. Donor-recipient human leukocyte antigen (HLA) match was 10/10 human leukocyte antigen (HLA-A, -B, -C, -DRB1, -DQB1) in 73% and MICA mismatch in 8.4%. Because of physical vicinity of the loci, MICA mismatch was significantly associated with mismatch at HLA-B and HLA-C. A higher rate of grade II-IV aGVHD was seen in MICA-mismatched patients (80% vs 40%, P = .003) irrespective of degree of HLA matching (HLA 10/10 match: 75% vs 39%, P = .02) and HLA any mismatch (83% vs 46%, P = .003). The rate of grade II-IV gastrointestinal aGVHD was also higher in MICA-mismatched patients (35% vs 17%, P = .05). We conclude that MICA may represent novel a transplantation antigen recognized by human allogeneic T cells. This study was registered at ClinicalTrials.gov (Identifier NCT00506922 [ClinicalTrials.gov] ).


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Limited role of MHC class I chain–related gene A (MICA) typing in assessing graft-versus-host disease risk after fully human leukocyte antigen–matched unrelated donor transplantation
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Response: MHC class I chain–related gene A (MICA) in unrelated donor transplantation
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E. Anderson, B. Grzywacz, H. Wang, T. Wang, M. Haagenson, S. Spellman, B. R. Blazar, J. S. Miller, and M. R. Verneris
Limited role of MHC class I chain-related gene A (MICA) typing in assessing graft-versus-host disease risk after fully human leukocyte antigen-matched unrelated donor transplantation
Blood, November 19, 2009; 114(21): 4753 - 4754.
[Full Text] [PDF]

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M. Fernandez-Vina, S. Parmar, R. Champlin, and M. de Lima
Response: MHC class I chain-related gene A (MICA) in unrelated donor transplantation
Blood, November 19, 2009; 114(21): 4754 - 4755.
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