HLA evolutionary divergence as a prognostic marker for AML patients undergoing allogeneic stem cell transplantation

M Roerden, A Nelde, JS Heitmann, R Klein… - Cancers, 2020 - mdpi.com
M Roerden, A Nelde, JS Heitmann, R Klein, HG Rammensee, WA Bethge, JS Walz
Cancers, 2020mdpi.com
The diversity of human leukocyte antigens (HLAs) enables the presentation of immense
repertoires of peptides, including tumor-associated antigens (TAAs). As a surrogate for
immunopeptidome diversity, the HLA evolutionary divergence (HED) between individual
HLA alleles might directly define the ability to present TAAs, a prerequisite for graft-versus-
leukemia effects. We therefore analyzed the impact of HED on survival within a cohort of 171
acute myeloid leukemia (AML) patients after matched donor allogeneic hematopoietic stem …
The diversity of human leukocyte antigens (HLAs) enables the presentation of immense repertoires of peptides, including tumor-associated antigens (TAAs). As a surrogate for immunopeptidome diversity, the HLA evolutionary divergence (HED) between individual HLA alleles might directly define the ability to present TAAs, a prerequisite for graft-versus-leukemia effects. We therefore analyzed the impact of HED on survival within a cohort of 171 acute myeloid leukemia (AML) patients after matched donor allogeneic hematopoietic stem cell transplantation (HSCT). Low HED (<25th percentile) of HLA class I (HEDclass I) or HLA-DR antigens (HEDDR) was a strong determinant for adverse overall survival after allogeneic HSCT (OS), with a hazard ratio for death of 1.9 (95% CI 1.2–3.2) and 2.1 (95% CI 1.3–3.4), respectively. Defining a cutoff value for the combined HEDtotal (HEDclass I and HEDDR), the respective 5 year OS was 29.7% and 64.9% in patients with low and high HEDtotal (p < 0.001), respectively. Furthermore, the risk of relapse was significantly higher in patients with low HEDtotal (hazard ratio (HR) 2.2, 95% CI 1.3–3.6) and event-free survival (EFS) was significantly reduced (5 year EFS 25.7% versus 54.4%, p < 0.001). We here introduce HED, a fundamental metric of immunopeptidome diversity, as a novel prognostic factor for AML patients undergoing allogeneic HSCT.
MDPI