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, Bertram L. Kasiske, Eric A. Engels

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

Original languageEnglish (US)
Pages (from-to)2453-2460
Number of pages8
JournalTransplantation
Volume100
Issue number11
DOIs
StatePublished - Nov 1 2016

Bibliographical note

Funding Information:
This research was supported in part by the Intramural Research Program of the National Cancer Institute.

Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.

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