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Impact of HLA disparity on overall mortality risk in patients with extensive chronic GVHD: The HLA Working Group of Japanese Society for Transplantation and Cellular Therapy

Bone Marrow Transplantation volume 58, pages 1257–1259 (2023)Cite this article

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Chronic graft-versus-host disease (cGVHD) is a significant complication after allogeneic hematopoietic cell transplantation (allo-HCT) [1]. cGVHD remains the major cause of late non-relapse mortality (NRM) after allo-HCT [2]. Previous studies that assessed the prognostic factors in patients with cGVHD focused primarily on non-HLA factors because the primary stem cell source was stem cells from HLA-matched donors [3, 4].

As a result of improved transplantation methods using alternative donor sources, including haploidentical related donors and cord blood transplantation (CBT), various kinds of stem cell sources are currently used for allo-HCT. With these stem cell sources, the presence of HLA disparity might impact the clinical outcome after GVHD development differently than with HLA-matched donors. The effects of HLA disparity might differ between stem cell sources, including bone marrow transplantation (BMT), peripheral blood stem cell transplantation (PBSCT), and CBT. Our group previously reported a significant impact of HLA disparity on overall mortality in patients who developed acute GVHD [5]. A previous study showed that the response rate to systemic corticosteroids in patients who developed acute GVHD differed according to the combination of stem cell source and HLA disparity [6]. In terms of NRM, univariate analysis in that study showed significant differences related to stem cell source and HLA disparity. Furthermore, HLA disparity was reported to be a risk factor for the development of cGVHD [7]. In contrast, no recent large study has assessed the effects of HLA disparity on clinical outcome after cGVHD. The aim of this study was to determine the impact of HLA disparity in patients who developed extensive cGVHD after allo-HCT.

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Fig. 1: The clinical outcome after extensive cGVHD.

Data availability

We are not able to share the data of this study. If you would like to ask about the data sharing, please make a contact with the corresponding author.

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Funding

This study was partly supported by a Health, Labor, and Welfare Sciences Research Grant (20FF1002). There are no relevant conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Shigeo Fuji

  2. Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

    Akitoshi Hakoda & Ayumi Shintani

  3. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junya Kanda

  4. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  5. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Noriko Doki

  6. Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Yuta Katayama

  7. Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  8. Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Aichi, Japan

    Yukiyasu Ozawa

  9. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Yoshinobu Kanda

  10. Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan

    Masatsugu Tanaka

  11. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Keisuke Kataoka

  12. Department of Hematology, Hokkaido University Hospital, Hokkaido, Japan

    Takahide Ara

  13. Department of Hematology and Oncology, Anjo Kosei Hospital, Aichi, Japan

    Masashi Sawa

  14. Department of Hematology/Oncology, Tokai University School of Medicine, Kanagawa, Japan

    Makoto Onizuka

  15. Department of Hematology, Tohoku University Hospital, Miyagi, Japan

    Yasushi Onishi

  16. Preparation Department, Japanese Red Cross Kinki Block Blood Center, Osaka, Japan

    Takafumi Kimura

  17. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  18. Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan

    Yoshiko Atsuta

  19. Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Aichi, Japan

    Yoshiko Atsuta

  20. Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan

    Satoko Morishima

Authors
  1. Shigeo Fuji
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  2. Akitoshi Hakoda
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  4. Takahiro Fukuda
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  12. Takahide Ara
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  15. Yasushi Onishi
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  16. Takafumi Kimura
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  18. Yoshiko Atsuta
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  19. Ayumi Shintani
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  20. Satoko Morishima
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Contributions

SF, JK, and SM designed the study and wrote the manuscript. AH and AS conducted the statistical analysis. TF, ND, YK, NU, YO, YK, MT, KK, TA, MS, MO, YO, TK, TI, and YA provided the data for the analysis. All coauthors agreed to submit the manuscript.

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Correspondence to Shigeo Fuji.

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The authors declare no competing interests.

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Fuji, S., Hakoda, A., Kanda, J. et al. Impact of HLA disparity on overall mortality risk in patients with extensive chronic GVHD: The HLA Working Group of Japanese Society for Transplantation and Cellular Therapy. Bone Marrow Transplant 58, 1257–1259 (2023). https://doi.org/10.1038/s41409-023-02076-3

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  • DOI: https://doi.org/10.1038/s41409-023-02076-3

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