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The shift from serologic human leukocyte antigen (HLA) testing to allele-specific molecular testing was a necessary prerequisite to successful unrelated donor transplantation. However, although there is a correlation between allelic mismatch, graft-versus-host disease (GVHD), and mortality, post-transplant patient outcomes remain somewhat unpredictable.
In this week's issue of Blood, Pidala and colleagues offer new insights into the prognostic significance of specific HLA class I mismatches and their impact on patient outcome. They report that specific amino acid substitutions in the peptide binding pockets of HLA-B and -C suggest an increased risk of chronic GVHD and mortality, while mismatches at the HLA-A binding pocket have no impact.
These results offer important insights into donor choice to improve outcomes for unrelated donor stem cell transplantation.
Amino acid substitution at peptide-binding pockets of HLA class I molecules increases risk of severe acute GVHD and mortality, Authors: Joseph Pidala, Tao Wang, Michael Haagenson, Stephen R. Spellman, Medhat Askar, Minoo Battiwalla, Lee Ann Baxter-Lowe, Menachem Bitan, Marcelo Fernandez-Viña, Manish Gandhi, Ann A. Jakubowski, Martin Maiers, Susana R. Marino, Steven G. E. Marsh, Machteld Oudshoorn, Jeanne Palmer, Vinod K. Prasad, Vijay Reddy, Olle Ringden, Wael Saber, Stella Santarone, Kirk R. Schultz, Michelle Setterholm, Elizabeth Trachtenberg, E. Victoria Turner, Ann E. Woolfrey, Stephanie J. Lee, and Claudio Anasetti, Blood - doi: 10.1182/blood-2013-05-501510
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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