Genetic Variant Boosts Risk of GVHD in Allogeneic Transplants

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According to a new study published in the New England Journal of Medicine, the risk of developing graft versus host disease (GVHD) following an allogeneic stem cell transplant is significantly increased in patients with a specific genetic variant.

The genetic variant is associated with increased expression of the HLA-DPB1 gene.

Specifically, patients who are found through genotyping to have the high-expression rs9277534G allele are at a 54 percent greater risk of developing GVHD following HLA-mismatched transplants compared with patients who have the corresponding low-expression rs9277534A allele.

Furthermore, the risk of death from causes other than disease recurrence was found to be 25 percent higher in patients undergoing transplants who have the high-expression allele.

“Our data provide new information on the role of HLA-DPB1 expression in transplantation associated risks that can be used to guide the selection of donors for future transplant recipients in order to minimize the risk of acute GVHD," concluded Effie Petersdorf MD of Fred Hutchinson Cancer Research Center in Seattle and co-authors. "We discovered that if rs9733534 genotypes had been known at the time of the search for an unrelated donor, almost 55% of recipients with rs9277534AG would have had suitable donors, and mismatching for their G-linked HLA-DPB1 allele could have been avoided."

The research team also concluded that the donors of choice for patients receiving an allogeneic transplant remain fully HLA-matched donors with the high-expression allele, and that they believed their study supported genotyping for both rs9277534 and HLA-DPB1 in the donor selection process.

Source: MedPage Today

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