• David Laurin, Dalil Hannani, Martine Pernollet, Agnès Moine, Joël Plumas, Jean-Claude Bensa, Jean-Yves Cahn, and Frédéric Garban.
• Etablissement Français du Sang Rhône-Alpes, and Immunobiologie et Immunothérapie des Cancers, Centre de Recherche INSERM Albert Bonniot, La Tronche, France.
• Transfusion. 2010 Feb 1; 50 (2): 418-28.

BackgroundAfter HLA-identical hematopoietic stem cell transplantation, minor histocompatibility (mH) antigen alloreactivity plays a dominant role in the development of graft-versus-host disease (GVHD) and graft versus leukemia (GVL).Study Design And MethodsWe have analyzed the mH alloreactivity (enzyme-linked immunospot [ELISpot] for interferon-gamma[IFN-gamma] assay) from 24 donor/recipient pairs over a period of 2 years of follow-up and correlated such alloreactivity with the development of GVHD or absence of relapse. Circulating specific T cells anti-mH with multimer HLA-peptides were also studied.ResultsWe show by ELISpot IFN-gamma assay that alloreactivity during the first 3 months from donor versus recipient or donor versus mismatched identified mH antigens is associated with acute GVHD and GVL effect. In addition, we demonstrate that the donor-versus-recipient reactivity observed after the third month is highly associated with chronic GVHD and GVL (p = 0.0007). Finally, we show by multimer HLA-peptide assay that mH epitope-specific T cells present after 3 months are statistically related to the GVL effect.ConclusionsOur results provide a robust method to monitor mH antigen graft-versus-host reaction and suggest that current identified mH have predictive value on GVHD and GVL.

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