Abstract:
:CTLA-4 is an inhibitory molecule that down-regulates T-cell activation. Although polymorphisms at CTLA-4 have been correlated with autoimmune diseases their association with clinical outcome after allogeneic hematopoietic stem cell transplantation (allo-HSCT) has yet to be explored. A total of 5 CTLA-4 single-nucleotide polymorphisms were genotyped on 536 HLA-identical sibling donors of allo-HSC transplants. Genotypes were tested for an association with patients' posttransplantation outcomes. The effect of the polymorphisms on cytotoxic T-lymphocyte antigen 4 (CTLA-4) mRNA and protein production were determined in 60 healthy control participants. We observed a reduction in the mRNA expression of the soluble CTLA-4 isoform in the presence of a G allele at CT60 and +49. Patients receiving stem cells from a donor with at least 1 G allele in position CT60 had worse overall survival (56.2% vs 69.8% at 5 years; P = .001; hazard ratio [HR], 3.80; 95% confidence interval [CI], 1.75-8.22), due to a higher risk of relapse (P = .049; HR, 1.71; 95% CI, 1.00-2.93). Acute graft-versus-host disease (aGVHD) was more frequent in patients receiving CT60 AA stem cells (P = .033; HR, 1.54; 95% CI, 1.03-2.29). This is the first study to report an association between polymorphisms at CTLA-4 and clinical outcome after allo-HSCT. The CT60 genotype influences relapse and aGVHD, probably due to its action on CTLA-4 alternative splicing.
journal_name
Bloodjournal_title
Bloodauthors
Pérez-García A,De la Cámara R,Román-Gómez J,Jiménez-Velasco A,Encuentra M,Nieto JB,de la Rubia J,Urbano-Ispizúa A,Brunet S,Iriondo A,González M,Serrano D,Espigado I,Solano C,Ribera JM,Pujal JM,Hoyos M,Gallardo D,GVHD\doi
10.1182/blood-2007-01-069781subject
Has Abstractpub_date
2007-07-01 00:00:00pages
461-7issue
1eissn
0006-4971issn
1528-0020pii
blood-2007-01-069781journal_volume
110pub_type
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