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@ARTICLE{Crivello:212409,
author = {P. Crivello and E. Arrieta-Bolaños$^*$ and M. He and T.
Wang and S. Fingerson and S. M. Gadalla and S. Paczesny and
S. G. E. Marsh and S. J. Lee and S. R. Spellman and Y.-T.
Bolon and K. Fleischhauer$^*$},
title = {{I}mpact of the {HLA} {I}mmunopeptidome on {S}urvival of
{L}eukemia {P}atients {A}fter {U}nrelated {D}onor
{T}ransplantation.},
journal = {Journal of clinical oncology},
volume = {41},
number = {13},
issn = {0732-183X},
address = {Alexandria, Va.},
publisher = {American Society of Clinical Oncology},
reportid = {DKFZ-2023-00128},
pages = {2416-2427},
year = {2023},
note = {2023 May 1;41(13):2416-2427},
abstract = {Immunopeptidome divergence between mismatched HLA-DP is a
determinant of T-cell alloreactivity and clinical
tolerability after fully HLA-A, -B, -C, -DRB1, -DQB1 matched
unrelated donor hematopoietic cell transplantation (UD-HCT).
Here, we tested this concept in HLA-A, -B, and -C
disparities after single class I HLA-mismatched UD-HCT.We
studied 2,391 single class I HLA-mismatched and 14,426 fully
HLA-matched UD-HCT performed between 2008 and 2018 for acute
leukemia or myelodysplastic syndromes. Hierarchical
clustering of experimentally determined peptide-binding
motifs (PBM) was used as a proxy for immunopeptidome
divergence of HLA-A, -B, or -C disparities, allowing us to
classify 1,629/2,391 $(68.1\%)$ of the HLA-mismatched UD-HCT
as PBM-matched or PBM-mismatched. Risks associated with
PBM-matching status were assessed by Cox proportional
hazards models, with overall survival (OS) as the primary
end point.Relative to full matches, bidirectional or
unidirectional PBM mismatches in graft-versus-host (GVH)
direction (PBM-GVH mismatches, $60.7\%)$ were associated
with significantly lower OS (hazard ratio [HR], 1.48; P <
.0001), while unidirectional PBM mismatches in
host-versus-graft direction or PBM matches (PBM-GVH matches,
$39.3\%)$ were not (HR, 1.13; P = .1017). PBM-GVH mismatches
also had significantly lower OS than PBM-GVH matches in
direct comparison (HR, 1.32; P = .0036). The hazards for
transplant-related mortality and acute and chronic
graft-versus-host disease but not relapse increased stepwise
from full HLA matches to single PBM-GVH matches, and single
PBM-GVH mismatches. A webtool for PBM-matching of single
class I HLA-mismatched donor-recipient pairs was
developed.PBM-GVH mismatches inform mortality risks after
single class I HLA-mismatched UD-HCT, suggesting that
prospective consideration of directional PBM-matching status
might improve outcome. These findings highlight
immunopeptidome divergence between mismatched HLA as a
driver of clinical tolerability in UD-HCT.},
cin = {ED01},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:36669145},
doi = {10.1200/JCO.22.01229},
url = {https://inrepo02.dkfz.de/record/212409},
}