Tumor Necrosis Factor Polymorphism Affects Transplantation Outcome in Patients with Myelodysplastic Syndrome but Not in Those with Chronic Myelogenous Leukemia, Independent of the Presence of HLA-DR15

作者：Newell Laura F; Gooley Ted; Hansen John A; Stirewalt Derek L; Petersdorf Effie W; Deeg H Joachim^*

来源：Biology of Blood and Marrow Transplantation, 2010, 16(12): 1700-1706.

DOI：10.1016/j.bbmt.2010.06.003

• Hematopoietic cell transplantation
• MDS
• TNFx
• Non-relapse mortality

Both the presence of HLA DR15 and tumor necrosis factor (TNF)-alpha levels have been reported to affect outcome after hematopoietic cell transplantation (HCT) Patients with a myelodysplastic syndrome (MDS) show a high prevalence of HLA-DR15 and express high levels of TNF a in the bone marrow The present analysis involving 7950 patients showed an HLA-DR15 frequency of 31% in patients with MDS corn pared with only 23% in patients with chronic myelogenous leukemia (CML) HLA-DR15 was more prevalent in Caucasian patients than in non-Caucasian patients (P = 01) The numbers of patients in the non-Caucasian subgroups were too small to allow further analysis Among Caucasian patients with MDS and CML the presence of HLA-DR15 did not significantly affect the occurrence of graft-versus host disease relapse nonrelapse mortality (NRM) or survival However there was a significant correlation between DR15 and TNF polymorphisms at position 308 among patients with MDS, and the TNF-308 AG genotype conferred an increased risk of NRM compared with the GG genotype (hazard ratio [HR] 1 49 P = 02) even after adjusting for DR15 Conversely the TNF-863 AA genotype was correlated with decreased overall mortality and NRM compared with the CC genotype (HR 0 36 P = 04 vs HR 0 13 P = 04) even after adjusting for DRIS There was no significant association between TNF 308 or -863 polymorphisms and transplantation outcome in CML patients These results suggest that TNF

• 出版日期2010-12