BACKGROUND: Graft-versus-host disease is the main complication of hematopoietic stem cell transplantation. Recently, pro- and anti-inflammatory cytokines and mismatches of minor histocompatibility antigens between HLA-identical sibling donor/recipient pairs have been implicated in the development of acute graft-versus-host disease. It is not known, however, whether these factors are independent of other clinically recognized risk factors such as age and disease stage. METHODS: In this study, we searched for risk factors of acute graft-versus-host disease using multivariate Cox regression analysis in 100 consecutive patients who underwent allogeneic stem cell transplantation from an HLA-identical sibling donor. Eight polymorphisms from five different cytokine genes were studied (tumor necrosis factor alpha, tumor necrosis factor beta, interleukin (IL) 6, IL-10, and interferon gamma). Mismatches for the minor histocompatibility antigen HA-1 were searched in HLA-A*0201 individuals. In addition to these new risk factors, patient, donor, disease, and transplant risk factors were analyzed by multivariate analysis using the Cox proportional hazards model. RESULTS: Acute graft-versus-host disease was independently associated with IL-10 gene polymorphisms both from the recipient (relative risk=7.9, P<0.0001) and the donor (relative risk=3.5, P=0.02), a donor's positive serology for cytomegalovirus, and HA-1 mismatches in HLA-A*0201 individuals (relative risk=2.8, P=0.05). Chronic graft-versus-host disease was independently associated with IL-6 gene polymorphism from the recipient (relative risk=4.2, P=0.02), older age (relative risk=2.5, P=0.0009), and previous acute graft-versus-host disease (relative risk=9.7, P=0.003). CONCLUSION: In addition to previously described clinical risk factors, genetic risk factors are independently associated with the risk of developing graft-versus-host disease and may, thus, be considered for the selection of the donor.
BACKGROUND:Graft-versus-host disease is the main complication of hematopoietic stem cell transplantation. Recently, pro- and anti-inflammatory cytokines and mismatches of minor histocompatibility antigens between HLA-identical sibling donor/recipient pairs have been implicated in the development of acute graft-versus-host disease. It is not known, however, whether these factors are independent of other clinically recognized risk factors such as age and disease stage. METHODS: In this study, we searched for risk factors of acute graft-versus-host disease using multivariate Cox regression analysis in 100 consecutive patients who underwent allogeneic stem cell transplantation from an HLA-identical sibling donor. Eight polymorphisms from five different cytokine genes were studied (tumor necrosis factor alpha, tumor necrosis factor beta, interleukin (IL) 6, IL-10, and interferon gamma). Mismatches for the minor histocompatibility antigen HA-1 were searched in HLA-A*0201 individuals. In addition to these new risk factors, patient, donor, disease, and transplant risk factors were analyzed by multivariate analysis using the Cox proportional hazards model. RESULTS: Acute graft-versus-host disease was independently associated with IL-10 gene polymorphisms both from the recipient (relative risk=7.9, P<0.0001) and the donor (relative risk=3.5, P=0.02), a donor's positive serology for cytomegalovirus, and HA-1 mismatches in HLA-A*0201 individuals (relative risk=2.8, P=0.05). Chronic graft-versus-host disease was independently associated with IL-6 gene polymorphism from the recipient (relative risk=4.2, P=0.02), older age (relative risk=2.5, P=0.0009), and previous acute graft-versus-host disease (relative risk=9.7, P=0.003). CONCLUSION: In addition to previously described clinical risk factors, genetic risk factors are independently associated with the risk of developing graft-versus-host disease and may, thus, be considered for the selection of the donor.
Authors: Jason W Chien; Xinyi Cindy Zhang; Wenhong Fan; Hongwei Wang; Lue Ping Zhao; Paul J Martin; Barry E Storer; Michael Boeckh; Edus H Warren; John A Hansen Journal: Blood Date: 2012-01-26 Impact factor: 22.113
Authors: John A Hansen; Effie W Petersdorf; Ming-Tseh Lin; Steven Wang; Jason W Chien; Barry Storer; Paul J Martin Journal: Immunol Res Date: 2008 Impact factor: 2.829
Authors: Paul J Martin; Wenhong Fan; Barry E Storer; David M Levine; Lue Ping Zhao; Edus H Warren; Mary E D Flowers; Stephanie J Lee; Paul A Carpenter; Michael Boeckh; Sangeeta Hingorani; Li Yan; Qiang Hu; Leah Preus; Song Liu; Stephen Spellman; Xiaochun Zhu; Marcelo Pasquini; Philip McCarthy; Daniel Stram; Xin Sheng; Loreall Pooler; Christopher A Haiman; Lara Sucheston-Campbell; Theresa Hahn; John A Hansen Journal: Blood Date: 2016-10-06 Impact factor: 22.113
Authors: Li-Hui Tseng; Barry Storer; Effie Petersdorf; Ming-Tseh Lin; Jason W Chien; Bryan M Grogan; Mari Malkki; Pei-Jer Chen; Lue P Zhao; Paul J Martin; John A Hansen Journal: Transplantation Date: 2009-03-15 Impact factor: 4.939