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McCarthy, P. L.

Publications and source records attributed to McCarthy, P. L..

2 recordsLinked to original sources

Associations of Minor Histocompatibility Antigens with Clinical Outcomes Following Allogeneic Hematopoietic Cell Transplantation

The role of minor histocompatibility antigens (mHAs) in mediating graft versus leukemia (GvL) and graft versus host disease (GvHD) following allogeneic hematopoietic cell transplantation (alloHCT) is recognized but not well-characterized. By implementing improved methods for mHA prediction in two large patient cohorts, this study aimed to comprehensively explore the role of mHAs in alloHCT by analyzing whether (1) the number of predicted mHAs, or (2) individual mHAs are associated with clinical outcomes using multi-variate survival models corrected for multiple testing. Cox proportional hazard results showed that patients with a class I mHA count greater than the population median had an increased hazard of GvHD mortality (HR=1.39, 95%CI 1.01, 1.77, P=0.046). Competing risk analyses identified the class I mHAs DLRCKYISL (gene GSTP), WEHGPTSLL (CRISPLD2) and STSPTTNVL (SERPINF2) were associated with increased GVHD death (HR=2.84, 95%CI 1.52, 5.31, P=0.01), decreased leukemia-free survival (LFS) (HR=1.94,95%CI 1.27, 2.95, P=0.044), and increased disease-related mortality (DRM) (HR=2.32, 95%CI 1.5, 3.6, P=0.008), respectively. One class II mHA YQEIAAIPSAGRERQ (TACC2) was associated with increased risk of treatment-related mortality (TRM) (HR=3.05, 95%CI 1.75, 5.31, P=0.02). WEHGPTSLL and STSPTTNVL were present in conjunction within HLA haplotype B*40:01-C*03:04 and showed a positive dose-response relationship with increased all-cause mortality and DRM and decreased LFS, indicating these two mHAs contribute to risk of mortality in an additive manner. Our study reports the first large scale investigation of the associations of predicted class I and class II mHA peptides with clinical outcomes following alloHCT. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=166 HEIGHT=200 SRC="FIGDIR/small/506092v1_ufig1.gif" ALT="Figure 1"> View larger version (35K): org.highwire.dtl.DTLVardef@1516a9aorg.highwire.dtl.DTLVardef@2db79aorg.highwire.dtl.DTLVardef@170e19aorg.highwire.dtl.DTLVardef@1eb7148_HPS_FORMAT_FIGEXP M_FIG C_FIG

genetics↗

Shared Graft Versus Leukemia Minor Histocompatibility Antigens in DISCOVeRY-BMT

T cell responses to minor histocompatibility antigens (mHAs) mediate graft versus leukemia (GvL) effects and graft versus host disease (GvHD) in allogeneic hematopoietic cell transplant (alloHCT). Therapies that boost T cell responses improve the efficacy of alloHCT; however, these have been limited by concurrent increases in the incidence and severity of GvHD. mHAs with expression restricted to hematopoietic tissue (GvL mHAs) are attractive targets for driving GvL without causing GvHD. Prior work to identify mHAs has focused on a small set of mHAs or population-level SNP association studies. We report here the discovery of a large set of novel GvL mHAs based on predicted peptide immunogenicity, restriction of expression to hematopoietic tissue or GvHD target organs, and degree of sharing among donor-recipient pairs (DRPs) in the DISCOVeRY-BMT dataset of 3231 alloHCT DRPs. The total number of predicted mHAs and count within each class of predicted mHAs significantly differed by recipient genomic ancestry group, with European American>Hispanic>African American for each. The number of mHAs also differed markedly by HLA allele, even among alleles of the same gene. From the pool of predicted mHAs, we identified the smallest sets of GvL mHAs needed to cover 100% of DRPs with a given HLA allele. We then used mass spectrometry to search for high population frequency mHAs for three common HLA alleles. We validated a total of 24 novel predicted GvL mHAs that cumulatively are found within 98.8%, 60.7%, and 78.9% of DRPs within DISCOVeRY-BMT that express HLA-A*02:01, HLA-B*35:01, and HLA-C*07:02 respectively. We also confirmed in vivo immunogenicity of one example novel mHA via coculture of healthy human CD8 T cells with mHA-pulsed dendritic cells. This work demonstrates that identification of shared mHAs is a feasible and promising technique for expanding mHA-targeting immunotherapeutics to larger numbers of patients.

cancer biology↗