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Translating the HLA-DPB1 T-cell epitope-matching algorithm into clinical practice

Bone Marrow Transplantation volume 48, pages 1510–1512 (2013)Cite this article

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A simple online tool can predict HLA-DPB1 T-cell epitope (TCE) matching. At least a quarter of hematopoietic SCT recipients could benefit from a better outcome by including HLA-DPB1 in unrelated donor (UD) selection algorithms.

HLA matching is recognized as a critical determinant of outcome for patients receiving UD hematopoietic stem cell transplantation for hematological disorders.1 Current UD selection algorithms depend on matching for HLA genes at an allelic level. Recent data, however, has suggested that certain HLA mismatches may be permissive (do not result in a poor clinical outcome), while others are nonpermissive (do result in a poor clinical outcome).2 The enormous degree of polymorphism in the HLA system makes UD selection algorithms complicated even when considering allelic level matching. Some tools, including Haplogic3 and Optimatch4 are available to assist search specialists by making predictions of the likelihood of an individual donor matching the patient. Currently, no search tool includes predictions for HLA-DPB1 matching. Interestingly, there are now strong clinical data for a survival disadvantage in patients who receive a transplant from a nonpermissive HLA-DPB1 TCE mismatched donor, defined on the basis of functional data, making this the first HLA locus where epitope matching can be routinely included in the donor selection process.5, 6, 7, 8 Here we describe an online, freely available tool, which we have developed to help those selecting donors to predict the immunogenicity of any given patient–donor HLA-DPB1 types. We also provide evidence for the usefulness of this in the clinical setting.

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Acknowledgements

We thank all the Graft Identification and Advisory Service staff at Anthony Nolan. This work was supported in part by a grant from the Associazione Italiana per la Ricerca sul Cancro (AIRC) to KF.

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Authors and Affiliations

  1. Anthony Nolan Research Institute, Royal Free Hospital, London, UK

    B E Shaw, J Robinson, J A Madrigal & S G E Marsh

  2. Cancer Institute, University College London, London, UK

    B E Shaw, J Robinson, J A Madrigal & S G E Marsh

  3. Royal Marsden NHS Foundation Trust, London, UK

    B E Shaw

  4. Unit of Molecular and Functional Immunogenetics, San Raffaele Scientific Institute, Milan, Italy

    K Fleischhauer

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  1. B E Shaw
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  2. J Robinson
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  3. K Fleischhauer
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  4. J A Madrigal
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  5. S G E Marsh
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Correspondence to B E Shaw.

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The authors declare no conflict of interest.

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Authors Contributions

All authors were involved in the drafting of the article or critical revision for important intellectual content. JR programmed the algorithm, and BS, KF, SGEM and JAM were involved in the conception and design and interpretation of the algorithm. BS and SGEM performed the clinical data collection and analysis.

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Shaw, B., Robinson, J., Fleischhauer, K. et al. Translating the HLA-DPB1 T-cell epitope-matching algorithm into clinical practice. Bone Marrow Transplant 48, 1510–1512 (2013). https://doi.org/10.1038/bmt.2013.91

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