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Blood, 1 April 2006, Vol. 107, No. 7, pp. 2984-2992. Prepublished online as a Blood First Edition Paper on December 15, 2005November 29, 2005; DOI 10.1182/blood-2005-08-3374. This Article Full Text (PDF) All Versions of this Article: 2005-08-3374v1 2005-08-3374v2 107/7/2984    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Fleischauer, K. Articles by La Nasa, G. Search for Related Content PubMed PubMed Citation Articles by Fleischauer, K. Articles by La Nasa, G. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 19, 2005 Accepted November 18, 2005 Graft rejection after unrelated donor hematopoietic stem cell transplantation for thalassemia is associated with non-permissive HLA-DPB1 disparity in host-versus-graft direction Katharina Fleischauer, Franco Locatelli*, Marco Zecca, Maria G Orofino, Claudio Giardini, Piero De Stefano, Andrea Pession, Angela M Iannone, Carlo Carcassi, Elisabetta Zino, and Giorgio La Nasa HLA Tissue Typing Laboratory, Immunohematology and Transfusion Medicine Service, San Raffaele Telethon Institute for Gene Therapy (HSR-TIGET), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Scientifico H.S. Raffaele, Milano, Italy Pediatric Hematology-Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico S. Matteo, Pavia, Italy Department of Biomedical and Biotechnological Sciences, Bone Marrow Transplantation Unit, University of Cagliari, Cagliari, Italy Department of Hematology, Bone Marrow Transplantation Unit of Muraglia, Ospedale San Salvatore, Pesaro, Italy Department of Pediatrics, University of Bologna, Ospedale S. Orsola-Malpighi, Bologna, Italy HLA Tissue Typing Laboratory, Immunohematology and Transfusion Medicine Service, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico S. Matteo, Pavia, Italy Department of Medical Genetics, University of Cagliari, Cagliari, Italy Bone Marrow Transplantation Unit, Ospedale Binaghi, Cagliari, Italy * Corresponding author; email: f.locatelli{at}smatteo.pv.it. The success of allogeneic hematopoietic stem cell transplantation (HSCT) from matched unrelated donors (UD) for beta-thalassemia may be hampered by occurrence of graft rejection. Here, we show that the rate of this complication can be reduced by selecting five-loci HLA-matched donors without non-permissive mismatches at HLA-DPB1, defined according to an algorithm previously described and based on principles of central T-cell tolerance. Seventy-two consecutive patients and their UD, prospectively selected for matching at the allelic level for HLA-A, B, C, DRB and DQB1 loci, were enrolled in the analysis. These pairs were either DPB1 matched/permissively mismatched (n=45, control group), or had at least one non-permissive DPB1 mismatch in the host-versus-graft (HvG; n=17) or in the graft-versus-host (GvH; n=10) direction. In multivariate analysis, the risk of rejection was significantly increased in the group with HvG disparity (RR=7.42; 95% CI=1.29-42.68; P=0.02) as compared to the control group. A lower, statistically significant, probability of thalassemia-free survival was found in patients belonging to the HvG as compared to controls (RR=5.15; 95% CI=1.58-16.82; P=0.01). These data suggest that in patients with thalassemia, the incidence of graft failure after HSCT may be reduced by appropriate selection of UD, performed taking into account the functional rules of immunogenetics. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: R. Crocchiolo, E. Zino, L. Vago, R. Oneto, B. Bruno, S. Pollichieni, N. Sacchi, M. P. Sormani, J. Marcon, T. Lamparelli, et al. Nonpermissive HLA-DPB1 disparity is a significant independent risk factor for mortality after unrelated hematopoietic stem cell transplantation Blood, August 13, 2009; 114(7): 1437 - 1444. [Abstract] [Full Text] [PDF] D. Lisini, M. Zecca, G. Giorgiani, D. Montagna, R. Cristantielli, M. Labirio, P. Grignani, C. Previdere, A. Di Cesare-Merlone, G. Amendola, et al. Donor/recipient mixed chimerism does not predict graft failure in children with {beta}-thalassemia given an allogeneic cord blood transplant from an HLA-identical sibling Haematologica, December 1, 2008; 93(12): 1859 - 1867. [Abstract] [Full Text] [PDF] B. E. Shaw, T. A. Gooley, M. Malkki, J. A. Madrigal, A. B. Begovich, M. M. Horowitz, A. Gratwohl, O. Ringden, S. G. E. Marsh, and E. W. Petersdorf The importance of HLA-DPB1 in unrelated donor hematopoietic cell transplantation Blood, December 15, 2007; 110(13): 4560 - 4566. [Abstract] [Full Text] [PDF] T. Kawase, Y. Morishima, K. Matsuo, K. Kashiwase, H. Inoko, H. Saji, S. Kato, T. Juji, Y. Kodera, T. Sasazuki, et al. High-risk HLA allele mismatch combinations responsible for severe acute graft-versus-host disease and implication for its molecular mechanism Blood, October 1, 2007; 110(7): 2235 - 2241. [Abstract] [Full Text] [PDF] F. Locatelli Reduced-Intensity Regimens in Allogeneic Hematopoietic Stem Cell Transplantation for Hemoglobinopathies Hematology, January 1, 2006; 2006(1): 398 - 401. [Abstract] [Full Text] [PDF]

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