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HLA and Risk of Diffuse Large B cell Lymphoma After Solid Organ Transplantation
Journal article   Open access   Peer reviewed

HLA and Risk of Diffuse Large B cell Lymphoma After Solid Organ Transplantation

Shehnaz K Hussain, Solomon B Makgoeng, Matthew J Everly, Marc T Goodman, Otoniel Martínez-Maza, Lindsay M Morton, Christina A Clarke, Charles F Lynch, Jon Snyder, Ajay Israni, …
Transplantation, Vol.100(11), pp.2453-2460
11/2016
DOI: 10.1097/TP.0000000000001025
PMCID: PMC4893345
PMID: 26636741
url
https://doi.org/10.1097/TP.0000000000001025View
Published (Version of record) Open Access

Abstract

Solid organ transplant recipients have heightened risk for diffuse large B cell lymphoma (DLBCL). The role of donor-recipient HLA mismatch and recipient HLA type on DLBCL risk are not well established. We examined 172 231 kidney, heart, pancreas, and lung recipients transplanted in the United States between 1987 and 2010, including 902 with DLBCL. Incidence rate ratios (IRRs) were calculated using Poisson regression for DLBCL risk in relation to HLA mismatch, types, and zygosity, adjusting for sex, age, race/ethnicity, year, organ, and transplant number. Compared with recipients who had 2 HLA-DR mismatches, those with zero or 1 mismatch had reduced DLBCL risk, (zero: IRR, 0.76, 95% confidence interval [95% CI], 0.61-0.95; one: IRR, 0.83; 95% CI, 0.69-1.00). In stratified analyses, recipients matched at either HLA-A, -B, or -DR had a significantly reduced risk of late-onset (>2 years after transplantation), but not early-onset DLBCL, and there was a trend for decreasing risk with decreasing mismatch across all 3 loci (P = 0.0003). Several individual recipient HLA-A, -B, -C, -DR, and -DQ antigens were also associated with DLBCL risk, including DR13 (IRR, 0.74; 95% CI, 0.57-0.93) and B38 (IRR, 1.48; 95% CI, 1.10-1.93), confirming prior findings that these 2 antigens are associated with risk of infection-associated cancers. In conclusion, variation in HLA is related to susceptibility to DLBCL, perhaps reflecting intensity of immunosuppression, control of Epstein-Barr virus infection among transplant recipients or chronic immune stimulation.
Histocompatibility Testing Humans Middle Aged Organ Transplantation - adverse effects HLA Antigens - immunology Adult Female Male Risk HLA-DR Antigens - immunology Lymphoma, Large B-Cell, Diffuse - etiology

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