Wiebke Stenger1, Annette Künkele1,2,3,4, Matthias Niemann5, Kremena Todorova6, Axel Pruß6, Johannes H Schulte1,3,4, Angelika Eggert1,2,3,4, Lena Oevermann1,2,3,4. 1. Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany. 2. Berlin Institute of Health (BIH), Berlin, Germany. 3. German Cancer Consortium (DKTK), Berlin, Germany. 4. German Cancer Research Center (DKFZ), Heidelberg, Germany. 5. PIRCHE AG, Berlin, Germany. 6. Center for Transfusion Medicine and Cell Therapies Berlin, Berlin, Germany.
Abstract
BACKGROUND: New strategies to optimize donor selection for hematopoietic stem cell transplantation (HSCT) have mainly been evaluated in adults, but the disease spectrum requiring HSCT differs significantly in children and has consequences for the risk of complications, such as graft-versus-host disease (GvHD). PROCEDURES: Here we evaluated whether HLA-DPB1 and Predicted Indirectly ReCognizable HLA-Epitope (PIRCHE) matching can improve donor selection and minimize risks specific for a pediatric cohort undergoing HSCT in Berlin between 2014 and 2016. RESULTS: The percentage of HLA-DPB1-mismatched HSCT in the pediatric cohort was in line with the general distribution among matched unrelated donor HSCT. Nonpermissive HLA-DPB1 mismatches were not associated with a higher incidence of GvHD, but the incidence of relapse was higher in patients undergoing HSCT from HLA-DPB1-matched transplantations. High PIRCHE-I scores were associated with a significantly higher risk for developing GvHD in patients undergoing HSCT from nine of ten matched unrelated donors. This finding persisted after including HLA-DPB1 into the PIRCHE analysis. CONCLUSIONS: Implementing PIRCHE typing in the donor selection process for HSCT in children could particularly benefit children with nonmalignant diseases and support further validation of PIRCHE-based donor selection in a larger number of children treated at different sites.
BACKGROUND: New strategies to optimize donor selection for hematopoietic stem cell transplantation (HSCT) have mainly been evaluated in adults, but the disease spectrum requiring HSCT differs significantly in children and has consequences for the risk of complications, such as graft-versus-host disease (GvHD). PROCEDURES: Here we evaluated whether HLA-DPB1 and Predicted Indirectly ReCognizable HLA-Epitope (PIRCHE) matching can improve donor selection and minimize risks specific for a pediatric cohort undergoing HSCT in Berlin between 2014 and 2016. RESULTS: The percentage of HLA-DPB1-mismatched HSCT in the pediatric cohort was in line with the general distribution among matched unrelated donor HSCT. Nonpermissive HLA-DPB1 mismatches were not associated with a higher incidence of GvHD, but the incidence of relapse was higher in patients undergoing HSCT from HLA-DPB1-matched transplantations. High PIRCHE-I scores were associated with a significantly higher risk for developing GvHD in patients undergoing HSCT from nine of ten matched unrelated donors. This finding persisted after including HLA-DPB1 into the PIRCHE analysis. CONCLUSIONS: Implementing PIRCHE typing in the donor selection process for HSCT in children could particularly benefit children with nonmalignant diseases and support further validation of PIRCHE-based donor selection in a larger number of children treated at different sites.
Authors: Jun Zou; Piyanuch Kongtim; Betül Oran; Vasilis Kosmoliaptsis; Yudith Carmazzi; Junsheng Ma; Liang Li; Gabriela Rondon; Samer Srour; Hannah C Copley; David Partlow; Stefan O Ciurea; Uri Greenbaum; Qing Ma; Elizabeth J Shpall; Richard E Champlin; Kai Cao Journal: Haematologica Date: 2022-04-01 Impact factor: 9.941