In a partially HLA-mismatched allogeneic transplant, a DPB1 mismatch is associated with a higher rate of morbidity and mortality from acute GVHD. In this study of 2,029 transplants reported to CIBMTR (Center for International Blood and Marrow Transplant Research), researchers found that an HLA-DPB1 mismatch is not sufficient by itself to lead to GVHD, but is dependent upon specific DPB1 allele variations in both the donor and the recipient. By measuring the HLA-DPB1 rs9277534 expression marker, researchers determined that acute GVHD is significantly more likely to develop when the recipient has a high-expression rs9277534 allele variant and the donor has a low-expression rs9277534 allele variant (HR, 1.54; 95% CI, 1.25 to 1.89; p<0.001). The authors conclude that HLA-DPB1 genotyping may be useful in minimizing the HCT recipients’ risk of acute GVHD.
Petersdorf, et al. N Engl J Med