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Blood, 1 April 2005, Vol. 105, No. 7, pp. 2973-2978.
Prepublished online as a Blood First Edition Paper on December 21, 2004; DOI 10.1182/blood-2004-09-3660.


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Submitted September 28, 2004
Accepted November 30, 2004

Antibody responses to H-Y minor histocompatibility antigens correlate with chronic graft versus host disease and disease remission

David B Miklos*, Haesook T Kim, Katherine H Miller, Luxuan Guo, Emmanuel Zorn, Stephanie J Lee, Ephraim P Hochberg, Catherine J Wu, Edwin P Alyea, Corey Cutler, Vincent Ho, Robert J Soiffer, Joseph H Antin, and Jerome Ritz

Department of Medical Oncology and Biostatistical Science, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
Department of Medical Oncology and Biostatistical Science, Dana-Farber Cancer Institute, Boston, MA, USA

* Corresponding author; email: DMiklos{at}Stanford.edu.

Minor histocompatibility antigens (mHA) are known targets of donor T cells after allogeneic hematopoietic stem cell transplantation (HSCT). In contrast, B cell responses to mHA have not been extensively characterized and the clinical significance of antibodies to mHA is unknown. We tested 121 HSCT patients and 134 healthy donors for IgG antibodies against 5 mHA encoded by genes on the Y chromosome (DBY, UTY, ZFY, RPS4Y and EIF1AY). Antibodies to at least one H-Y protein developed in 52% of male patients with female donors compared to 8.7% of male patients with male donors (p<0.0001) and in 41.4% of healthy females compared to 7.8% of healthy males (p<0.0001). H-Y antibodies develop 4-12 months after transplantation and persist for long periods. The clinical significance of H-Y antibodies was characterized in 75 male patients with hematologic malignancies who received stem cells from female donors (F{Rightarrow}M HSCT). The presence of H-Y antibodies correlated with chronic GVHD by univariate (OR=15.5, p<0.0001) and multivariable logistic regression analysis (OR 56.5; p<0.0001). Antibody response to H-Y antigens was also associated with maintenance of disease remission (p<0.0001). B cells may provide a new target for immune intervention in chronic GVHD.


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