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Different mechanisms causing loss of mismatched human leukocyte antigens in relapsing t(6;11)(q27;q23) acute myeloid leukemia after haploidentical transplantation

Authors

  • Hiroya Tamaki,

    Corresponding author
    1. Laboratory of Cell Transplantation, Institute for Advanced Medical Science, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
    • Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Tatsuya Fujioka,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Kazuhiro Ikegame,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
    2. Laboratory of Cell Transplantation, Institute for Advanced Medical Science, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Satoshi Yoshihara,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Katsuji Kaida,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Kyoko Taniguchi,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Ruri Kato,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Taduko Tokugawa,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Jun Nakata,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Takayuki Inoue,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Aya Yano,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Ryoji Eguchi,

    1. Laboratory of Cell Transplantation, Institute for Advanced Medical Science, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Masaya Okada,

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
    2. Laboratory of Cell Transplantation, Institute for Advanced Medical Science, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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  • Etsuko Maruya,

    1. Terasaki Foundation Laboratory, Los Angeles, CA, USA
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  • Hiroh Saji,

    1. HLA Foundation Laboratory, Kyoto, Japan
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  • Hiroyasu Ogawa

    1. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
    2. Laboratory of Cell Transplantation, Institute for Advanced Medical Science, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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Correspondence Hiroya Tamaki, MD, PhD, Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501, Japan. Tel: +81 798 45 6886; Fax: +81 798 45 6887; e-mail: tamakhi@hyo-med.ac.jp

Abstract

Mismatched human leukocyte antigens (HLAs) on leukemic cells can be targeted by donor T cells in HLA-mismatched/haploidentical stem cell transplantation. In two cases of acute myeloid leukemia with t(6;11)(q27;q23) abnormality presented here, flow cytometry analysis showed a lack of HLA-A unshared between recipients and donors in relapsing leukemic cells after HLA-haploidentical transplantation. However, high-resolution HLA genotyping showed that one case lacked a corresponding HLA haplotype, whereas the other preserved it. These cases suggest that leukemic cells, which lacked mismatched HLA expression, might have an advantage in selective expansion under donor T-cell immune surveillance after HLA-haploidentical transplantation. Most importantly, down-regulation of unshared HLA expression potentially occurs by genetic alterations other than loss of HLA alleles.

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