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Blood, 1 September 2008, Vol. 112, No. 5, pp. 2120-2128. Prepublished online as a Blood First Edition Paper on June 13, 2008; DOI 10.1182/blood-2007-07-100222. This Article Full Text (PDF) Supplemental Table and Figure All Versions of this Article: blood-2007-07-100222v1 112/5/2120    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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mullighan, C. G. Articles by Bardy, P. G Search for Related Content PubMed PubMed Citation Articles by Mullighan, C. G. Articles by Bardy, P. G Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 9, 2007 Accepted May 16, 2008 Mannose-binding lectin status is associated with risk of major infection following myeloablative sibling allogeneic hematopoietic stem cell transplantation Charles G. Mullighan*, Susan L Heatley, Silke Danner, Melinda M Dean, Kathleen Doherty, Uwe Hahn, Kenneth F Bradstock, Robyn Minchinton, Anthony P. Schwarer, Jeff Szer, and Peter G Bardy Pathology, St Jude Children's Research Hospital, Memphis, TN, United States Research and Development, Australian Red Cross Blood Service, Adelaide, SA, Australia Cooperative Research Center for Vaccine Technology, Australian Red Cross Blood Service, Kelvin Grove, Qld, Australia Institute of Medical and Veterinary Science, Adelaide, SA, Australia Haematology Department, Westmead Hospital, Sydney, NSW, Australia Haematology, Alfred Hospital, Melbourne, Vic, Australia Dept of Clinical Haematology and BMT Service, The Royal Melbourne Hospital, Melbourne, Vic, Australia * Corresponding author; email: charles.mullighan{at}stjude.org. Mannose-binding lectin (MBL) is a mediator of innate immunity that influences the risk of infection in a range of clinical settings. We previously reported associations between MBL2 genotype and infection in a retrospective study of myeloablative allogeneic hematopoietic stem cell transplantation. However, other studies have been inconclusive, and the role of MBL in reduced intensity conditioning (RIC) transplants is unknown. Here we report a prospective study examining MBL2 genotype, MBL levels and risk of major infection following HLA-matched sibling myeloablative (N=83) and RIC (n=59) HCT. Baseline MBL levels were higher in recipients than donors (P<0.0001), and recipient MBL levels increased during the peri-transplant period (P=0.0002), most notably in MBL2 wild-type individuals receiving myeloablative total body irradiation (mTBI). MBL2 coding mutations were associated with major infection in recipients receiving mTBI. The cumulative incidence of major infection in recipient harboring an MBL2 mutation receiving mTBI was 70.6%, compared with 31.1% of those without mutations not receiving mTBI. (P=0.01). MBL status was not associated with infection in RIC transplants. These results confirm the association of MBL status with risk of infection in myeloablative, TBI-conditioned transplants. Studies examining the role of MBL replacement therapy to prevent infection in this setting should be considered. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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