We retrospectively analyzed the correlation between HLA class II DNA typing, MLR, rejection and acute GVHD in 14 patient-donor pairs, who had undergone HLA serologically identical related bone marrow transplantation, in order to evaluate the histocompatibility tests for the clinical outcome after transplantation.
Severe acute GVHD (≥grade II) were seen in 7, rejection in 2 and MLR (rejection side)-positivity were in 1 out of 14 patients. However, the HLA class II genotypes of DRB1, DRB3, DQB1 and DPB1 were completely identical between them.
Among the 7 patients with severe acute GVHD, one patient “F” died day 15 of grade IV GVHD after transplantation. In this case, there were no considerable risk factors such as ABO or sex mismatch between the patient and donor, and the donor had not alloimmunized by previous transfusion.
Two patients, J and K, rejected the donor's bone marrow and only the patient K showed recipient anti-donor reactivity in MLR before the transplantation. In this case, the donor was male and the patient was female who might have been already alloimmunized by pregnancy and transfusion.
These observations strongly indicate the importance of minor histocompatibility antigens in HLA genotypically identical allogeneic bone marrow transplantation.
抄録全体を表示