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Norden J, Pearce KF, Irving JAE, Collin MP, Wang XN, Wolff D, Kolb HJ, Socie G, Kuzmina Z, Greinix H, Holler E, Rocha V, Gluckman E, Hromadnikova I, Dickinson AM. The influence of glucocorticoid receptor single nucleotide polymorphisms on outcome after haematopoietic stem cell transplantation. Int J Immunogenet 2018; 45:247-256. [PMID: 30043490 DOI: 10.1111/iji.12380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 04/25/2018] [Accepted: 05/29/2018] [Indexed: 11/26/2022]
Abstract
Haematopoietic stem cell transplantation (HSCT) remains the only cure for most haematological malignancies, however, the mortality rate remains high. Complications after HSCT include relapse, graft versus host disease (GvHD), graft rejection and infection. Over the last few years several groups, have demonstrated that non-HLA gene polymorphisms can be predictive of outcome after HSCT. Since the glucocorticoid cortisol is pivotal in the regulation of the immune system, we decided to examine single nucleotide polymorphisms (SNPs; rs6198, rs33388 and rs33389) within the glucocorticoid receptor (GR) and correlate with HSCT outcome. The training set consisted of patients (n = 458) who underwent HSCT for acute leukaemia between 1983 and 2005. In the recipients, the absence of the ACT haplotype and absence of the T allele of rs33388 were associated with decreased OS and the absence of the ACT haplotype, the absence of the T allele of rs33388 and the presence of the ATA haplotype were associated with increased risk of relapse. In addition, the presence of the ACT haplotype in the recipient showed a trend to be associated with increased risk of chronic graft versus host disease (cGvHD). The patients in this cohort received mainly myeloablative conditioning (n = 327). The SNPs in the glucocorticoid receptor were then investigated in a validation set (n = 251) of HSCT patients transplanted for acute leukaemia from 2006. This cohort contained significantly more patients that had received reduced intensity conditioning (RIC). Some of the results could be validated in these patients. However, contrary to the training set, the absence of the haplotype ACT in the donor in this cohort was associated with increased risk of cGvHD. Differences in the conditioning were shown to influence the results. These results are the first to associate GR SNPs with HSCT outcome and demonstrate the inherent problems of replicating SNP association studies in HSCT, due to different pre-transplant regimens.
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Affiliation(s)
- Jean Norden
- Haematological Sciences, Institute of Cellular Medicine, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Kim F Pearce
- Haematological Sciences, Institute of Cellular Medicine, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Julie A E Irving
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Matthew P Collin
- Haematological Sciences, Institute of Cellular Medicine, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Xiao N Wang
- Haematological Sciences, Institute of Cellular Medicine, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Daniel Wolff
- Department of Haematology and Oncology, University of Regensburg, Regensburg, Germany
| | | | - Gerard Socie
- Department of Haematology, St Louis Hospital, Paris, France
| | - Zoya Kuzmina
- Department of Internal Medicine I, Bone Marrow Transplantation, Medical University of Vienna, Vienna, Austria
| | - Hildegard Greinix
- Department of Internal Medicine, Division of Haematology, Medical University of Graz, Graz, Austria
| | - Ernst Holler
- Department of Haematology and Oncology, University of Regensburg, Regensburg, Germany
| | | | | | - Ilona Hromadnikova
- Department of Molecular Biology and Cell Pathology, Third faculty of Medicine, Charles University, Prague, Czech Republic
| | - Anne M Dickinson
- Haematological Sciences, Institute of Cellular Medicine, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
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