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Blood, 1 February 2006, Vol. 107, No. 3, pp. 1220-1226.
Prepublished online as a Blood First Edition Paper on October 18, 2005; DOI 10.1182/blood-2005-08-3121.
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Submitted August 3, 2005
Accepted September 23, 2005
HLA-DPB1 matching status has significant implications for recipients of Unrelated Donor Stem Cell Transplants
Bronwen E Shaw*, Steven G Marsh, Neema P Mayor, Nigel H Russell, and J A Madrigal
Anthony Nolan Research Institute, London, United Kingdom; Nottingham City Hospital, Nottingham, United Kingdom
Anthony Nolan Research Institute, London, United Kingdom; Royal Free and University College London Medical School, London, United Kingdom
Anthony Nolan Research Institute, London, United Kingdom
Nottingham City Hospital, Nottingham, United Kingdom
* Corresponding author; email: bshaw{at}doctors.org.uk.
Studies in Unrelated Donor (UD) Haematopoietic Stem Cell Transplants (HSCT), show an impact of the matching status of HLA-DPB1 on complications. We analysed 423 UD-HSCT pairs. Most protocols included T cell depletion (TCD). All pairs had high resolution tissue typing performed for six HLA loci. 282 pairs were matched at 10/10 alleles (29% were DPB1 matched). In 141 HLA mismatched pairs, 28% were matched for DPB1. In the10/10 matched pairs (N=282), the three year probability of relapse was 61%. This was significantly higher in DPB1 matched pairs (74%) as compared to DPB1 mismatched pairs (56%) (log rank, p=0.001). This finding persisted in multivariate analysis. In the group overall (N=423), relapse was also significantly increased if DPB1 was matched (log rank; p=0.0001). These results were similar in CML (p=0.0009) and ALL (p=0.013). In ALL DPB1 matched pairs had a significantly worse overall survival (log rank; p=0.025). Thus, in recipients of TCD UD-HSCT, a match for DPB1 is associated with a significantly increased risk of disease relapse, irrespective of the matching status for the other HLA molecules. It is possible that this effect is especially apparent following TCD transplants and invites speculation about the function of DPB1 within the immune system.

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