1. ¹Faculty of Health Science, Kanazawa University School of Medicine, Kanazawa City, Japan
2. ²Division of Transfusion Medicine, Kanazawa University Hospital, Kanazawa City, Japan
3. ³Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa City, Japan
4. ⁴Division of Bone Marrow Transplantation, Niigata University Medical and Dental Hospital, Niigata City, Japan
5. ⁵First Department of Internal Medicine, University of Occupational and Environment Health, Kitakyuhsyu City, Japan
6. ⁶Medical Laboratory Division, Niigata University Medical and Dental Hospital, Niigata City, Japan
7. ⁷Division of Hematology, Niigata University Graduate School of Medical and Dental Science, Niigata City, Japan
8. ⁸First Department of Internal Medicine, Kyushu University School of Medicine, Fukuoka City, Japan

Correspondence: Dr S Shiobara, Division of Transfusion Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa City 920-8641, Japan. E-mail: shiobara@med.kanazawa-u.ac.jp

Received 27 February 2006; Revised 15 August 2006; Accepted 18 August 2006; Published online 18 September 2006.

Abstract

We determined the alleles of five polymorphic molecules including HA-1 and four adhesion molecules for 106 patients transplanted with HLA-identical stem cell grafts and investigated the association of mismatches as correlates of relapse and graft-versus-host disease (GVHD). All 106 recipients underwent stem cell transplantation (SCT) after myeloablative conditioning between 1985 and 2002. Risk status of disease at SCT was standard (n=63) and high (n=42). After SCT, 36, 49 and 33 developed acute GVHD, chronic GVHD and relapsed, respectively. Our patients relapsed at rates of 16.7 and 38.6% with one or more and without incompatibilities (P=0.013). The relapse rates of patients with CD62L, CD31 codon 563, CD31 codon 125, HA-1 and CD49b incompatibilities were 5.9, 11.8, 15.4, 16.0 and 33.3%, respectively. The frequency of acute GVHD did not differ regardless of incompatibilities. In standard-risk group, the accumulated relapse rates of 19 and 44 patients with and without minor histocompatibility antigen incompatibility were 22% and unexpectedly 66%, respectively (P=0.02). The probability of 12-year survival was 88% in the former and 66% in the latter patients (P=0.03). Our data suggest that incompatibility of CD62L, CD31 codon 563 and CD31 codon 125 contributes to a graft-versus-leukemia effect rather than to GVHD, resulting in prolonged survival after HLA-identical SCT.