Predicting survival using clinical risk scores and non-HLA immunogenetics

Bone Marrow Transplant. 2015 Nov;50(11):1445-52. doi: 10.1038/bmt.2015.173. Epub 2015 Jul 27.

Abstract

Previous studies of non-histocompatibility leukocyte antigen (HLA) gene single-nucleotide polymorphisms (SNPs) on subgroups of patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) revealed an association with transplant outcome. This study further evaluated the association of non-HLA polymorphisms with overall survival in a cohort of 762 HSCT patients using data on 26 polymorphisms in 16 non-HLA genes. When viewed in addition to an already established clinical risk score (EBMT-score), three polymorphisms: rs8177374 in the gene for MyD88-adapter-like (MAL; P=0.026), rs9340799 in the oestrogen receptor gene (ESR; P=0.003) and rs1800795 in interleukin-6 (IL-6; P=0.007) were found to be associated with reduced overall survival, whereas the haplo-genotype (ACC/ACC) in IL-10 was protective (P=0.02). The addition of these non-HLA polymorphisms in a Cox regression model alongside the EBMT-score improved discrimination between risk groups and increased the level of prediction compared with the EBMT-score alone (gain in prediction capability for EBMT-genetic-score 10.8%). Results also demonstrated how changes in clinical practice through time have altered the effects of non-HLA analysis. The study illustrates the significance of non-HLA genotyping prior to HSCT and the importance of further investigation into non-HLA gene polymorphisms in risk prediction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allografts
  • Cause of Death
  • Child
  • Estrogen Receptor alpha / genetics
  • Female
  • Follow-Up Studies
  • Genotype
  • Graft vs Host Disease / mortality
  • Haplotypes
  • Hematologic Neoplasms / mortality
  • Hematologic Neoplasms / therapy*
  • Hematopoietic Stem Cell Transplantation / mortality*
  • Histocompatibility
  • Humans
  • Infections / mortality
  • Interleukin-10 / genetics
  • Interleukin-6 / genetics
  • Kaplan-Meier Estimate
  • Male
  • Membrane Glycoproteins / genetics
  • Middle Aged
  • Multiple Organ Failure / mortality
  • Polymorphism, Single Nucleotide*
  • Prognosis
  • Proportional Hazards Models
  • Receptors, Interleukin-1 / genetics
  • Risk Assessment / methods*
  • Transplantation Conditioning / adverse effects
  • Treatment Outcome

Substances

  • ESR1 protein, human
  • Estrogen Receptor alpha
  • IL10 protein, human
  • IL6 protein, human
  • Interleukin-6
  • Membrane Glycoproteins
  • Receptors, Interleukin-1
  • TIRAP protein, human
  • Interleukin-10