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  • American Society of Hematology  (7)
  • 1
    In: Blood, American Society of Hematology, Vol. 128, No. 22 ( 2016-12-02), p. 4112-4112
    Abstract: Introduction Primary central nervous system lymphoma (PCNSL) is a rare subtype of non-Hodgkin's lymphoma. Although most cases (~95%) show histology of diffuse large B-cell lymphomas (DLBCLs), PCNSL shows very different biological and clinical characteristics from systemic DLBCL. Nevertheless, our knowledge about the molecular pathogenesis of PCNSL and genetic differences between both lymphomas are still incomplete. Method To obtain a comprehensive view of the genetic alterations, including mutations in non-coding regions as well as structural variants (SVs), we performed whole-genome sequencing (WGS) of 22 PCNSL cases. Subsequently, to unravel the genetic differences between PCNSL and systemic DLBCL, we re-analyzed WGS data from systemic DLBCL cases (N = 47) generated by the Cancer Genome Atlas Network (TCGA) and Cancer Genome Characterization Initiative (CGCI) using our in-house pipeline. The mean depth of WGS for tumor samples were 49X and 37X for PCNSL and DLBCL cases, respectively. Whole-exome sequencing (WES) was also performed for an additional 37 PCNSL cases to reliably capture driver alterations and also to analyze mutational signatures in PCNSL, which were compared to those obtained from the WES data for DLBCL from TCGA (N = 49). Results WGS identified 10.5 and 5.6 mutations per mega-base on average in PCNSL and DLBCL, respectively. We first explored the density of somatic mutations and identified 64 and 33 genomic loci showing significantly high mutation densities in PCNSL and DLBCL, respectively. In PCNSL, most of these loci corresponded to known targets of somatic hypermutations (SHMs) induced by activation-induced cytidine deaminase (AID), including those for IG genes (IGK, IGH and IGL), BCL6, and PIM1, as well as those for known driver genes, such as MYD88 and CD79B. Although most of the hypermutated regions were overlapped between PCNSL and DLBCL, some regions were differentially affected by hypermutations between both lymphoma types. For example, BCL2 and SGK1 loci were frequently affected by SHMs in germinal center B-cell (GCB) DLBCL, while not in PCNSL. In terms of non-coding driver mutations, we identified frequent mutations in a PAX5 enhancer region in 8/22 (36%) of PCNSL and 18/47 (38%) of DLBCL cases. SVs were common in both lymphoma types, where 104 (PCNSL) and 57 (DLBCL) SVs were detected per sample. SV clusters were identified in 34 (PCNSL) and 13 (DLBCL) regions, of which several clusters were commonly seen in both PCNSL and DLBCL, and included IG loci, BCL6, FHIT, TOX and CDKN2A. In PCNSL, SVs were clustered within the loci for known targets of SHMs, such as BCL6, BTG2 and PIM1. As was the case with somatic mutations, the SV cluster corresponding to BCL2 was only seen in DLBCL. We then analyzed these clustered breakpoints for their proximity to known sequence motifs targeted by AID (CpG and WGCW). Breakpoints of SVs found in the targets of SHMs, including PIM1, BCL6, BTG2 and BCL2, showed an enrichment at or near the CpG, supporting the involvement of AID in the generation of these SVs. By analyzing these SV clusters, we identified several novel driver genes in PCNSL. For example, WGS and WES identified an enrichment of breakpoints of deletions (7/22) and loss-of-function mutations (6/37) in GRB2, strongly indicating its tumor suppressor role in PCNSL. We also analyzed pentanucleotide signatures of mutations in coding sequences detected by WES of PCNSL and DLBCL, taking into consideration the two adjacent bases 3' and 5' of the substitutions as well as transcription strand biases. Two predominant mutational signatures were identified in PCNSL: the AID signature characterized by C 〉 T mutations within the WRCY motif targeted by SHMs and the age-related signature involving C 〉 T transition at CpG dinucleotides. For DLBCL, an additional signature (signature 17 according to Alexandrov et al.) was detected as well, which had been reported in DLBCL with an unknown mechanistic basis. Conclusions Comprehensive genomic analyses of a large cohort of PCNSL and DLBCL cases have revealed the major targets of somatic mutations and SVs, including novel driver genes. In both PCNSL and systemic DLBCL, an enhanced AID activity is thought to be associated with generation of both SHMs and SVs, although the activity and targets of AID seem to substantially differ between both lymphoma types, suggesting distinct pathogenesis therein. Disclosures Kataoka: Boehringer Ingelheim: Honoraria; Yakult: Honoraria; Kyowa Hakko Kirin: Honoraria. Ogawa:Takeda Pharmaceuticals: Consultancy, Research Funding; Kan research institute: Consultancy, Research Funding; Sumitomo Dainippon Pharma: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2016
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  • 2
    In: Blood, American Society of Hematology, Vol. 115, No. 23 ( 2010-06-10), p. 4664-4670
    Abstract: Although the effects of human leukocyte antigen (HLA) locus matching on clinical outcome in unrelated hematopoietic stem cell transplantations have been characterized, the biologic implications of HLA haplotypes have not been defined. We demonstrated the genetic fixity of Japanese conserved extended haplotypes by multi–single nucleotide polymorphism analysis in 1810 Japanese donor-recipient pairs matching with HLA-A, -B, -C, -DRB1, and -DQB1 alleles. Three major Japanese conserved extended haplotypes (named HP-P1, HP-P2, and HP-P3) were essentially completely conserved at least in the 3.3-Mb HLA region from HLA-A to -DPB1, and extended far beyond HLA-A. The risk of acute graft-versus-host disease (GVHD) of these HLA haplotypes was assessed with multivariate Cox regression in 712 patients transplanted from HLA fully (HLA-A, B, C, DRB1, DQB1, and DPB1) matched unrelated donors. HP-P2 itself reduced the risk of grade 2 to 4 acute GVHD (hazard ratio [HR] = 0.63; P = .032 compared with HP-P2-negative), whereas HP-P3 tended to increase the risk (HR = 1.38; P = .07). Among 381 patients with HP-P1, HP-P1/P3 (HR = 3.35; P = .024) significantly increased the risk of acute GVHD compared with homozygous HP-P1. This study is the first to demonstrate that a genetic difference derived from HLA haplotype itself is associated with acute GVHD in allogeneic hematopoietic stem cell transplantation.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
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  • 3
    In: Blood, American Society of Hematology, Vol. 131, No. 7 ( 2018-02-15), p. 808-817
    Abstract: HLA-DPB1 alleles diverged into 2 major groups according to highly conserved DNA sequences Ex3-3′UTR. Two evolutionarily different HLA-DPB1 gene regions complementarily affect aGVHD in HLA-DPB1 mismatch UR-HCT.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
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  • 4
    In: Blood, American Society of Hematology, Vol. 113, No. 12 ( 2009-03-19), p. 2851-2858
    Abstract: The finding that the risk of relapse in hematologic malignancy decreases after allogeneic hematopoietic stem cell transplantation (HSCT) has lead to the concept of a graft-versus-leukemia (GVL) effect. However, this beneficial effect is considered to be frequently offset by graft-versus-host disease (GVHD). Thus, improving HSCT outcomes by separating GVL from GVHD is a key clinical issue. This cohort study registered 4643 patients with hematologic malignancies who received transplants from unrelated donors. Six major human leukocyte antigen (HLA) loci were retrospectively genotyped. We identified 4 HLA-Cw and 6 HLA-DPB1 mismatch combinations responsible for a decreased risk of relapse; of these, 8 of 10 combinations were different from those responsible for severe acute GVHD, including all 6 of the HLA-DPB1 combinations. Pairs with these combinations of HLA-DPB1 were associated with a significantly better overall survival than were completely matched pairs. Moreover, several amino acid substitutions on specific positions responsible for a decreased risk of relapse were identified in HLA-Cw, but not in HLA-DPB1. These findings might be crucial to elucidating the mechanism of the decreased risk of relapse on the basis of HLA molecule. Donor selection made in consideration of these results might allow the separation of GVL from acute GVHD, especially in HLA-DPB1 mismatch combinations.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 5
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 708-708
    Abstract: Although the effect of allele matching of each HLA locus on the clinical outcome of unrelated hematopoietic stem cell transplantation (UR-HSCT) has been characterized, the effect of HLA allele or haplotype (HP) itself has not been well elucidated. The HLA region is recognized as one of the most important genetic regions associated with human disease, especially autoimmune and infectious diseases. We therefore hypothesized that the immunological response and the clinical outcome following UR-HSCT depend not only on HLA allele matching but also on the HLA allele itself or HLA-linked genetic background of the patient and donor. Methods We analyzed 5237 patients who received T-cell-replete bone marrow transplants from serologically HLA-A, -B, and -DR antigen-matched unrelated donors facilitated by the Japan Marrow Donor Program between 1993 and 2008. HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1 alleles were retrospectively genotyped. HLA allele frequencies were calculated by direct counting, and multi-locus HLA HP frequencies were estimated using the maximum-likelihood method with EM algorithm of PyPop software. Patients were stratified by HLA-matching status into a full match (FM) group (12/12-matched, n=733) and a mismatch (MM) group (≤11/12-matched, n=4504). The effect of HLA alleles or HPs with a frequency greater than 5% on acute graft-versus-host disease (aGVHD) and overall survival (OS) was analyzed using a multivariate competing risk regression model. The results are expressed as hazard ratios (HRs) comparing specific allele/haplotype-positive group to -negative group. Results For each allele, the number of HLA alleles significantly associated with aGVHD (p 〈 .01) in the MM group, were as follows: HLA-A (1 of 10), HLA-B (2 of 17), HLA-C (3 of 15), HLA-DRB1 (1 of 17), HLA-DQB1 (1 of 11) and HLA-DPB1 (0 of 10). In contrast, only one HLA-DPB1 allele was significantly associated with aGVHD in the FM group. The following patient and donor HLA alleles were significantly associated with a reduced risk of aGVHD in the MM group: HLA-A*33:03, C*14:03, B*44:03, DRB1*13:02, and DQB1*06:04. These alleles are located on a common HP (HP-P2) in the Japanese population, which showed a similar effect on grade II-IV (n=534; HR 0.79; p=.001) and III-IV (HR 0.70; p=.004) aGVHD. Strong linkage disequilibrium (LD) hampered determination of the allele responsible for the reducing risk of aGVHD. A significant association with an increased risk of grade III-IV aGVHD and a poor OS was observed in patient HLA-B*51:01 (n=756; aGVHD: HR 1.51, p 〈 .001; OS: HR 1.19, p=.003, respectively) and donor HLA-B*51:01 (n=773; HR 1.46, p 〈 .001; HR 1.15, p=.015) , patient HLA-C*14:02 (n=599; HR 1.55, p 〈 .001; HR 1.19, p=.007), and donor HLA-C*15:02 (n=226; HR 1.62, p 〈 .001; HR 1.38, p=.001) in the MM group. HLA-B*51:01 demonstrated strong positive LD with HLA-C*14:02 and -C*15:02. A significant association with an increased risk of grade III-IV aGVHD and a poor OS was also observed in patient HLA-C*14:02-B*51:01 (n=586; HR 1.52, p 〈 .001; HR 1.19; p=.007) and donor HLA-C*15:02-B*51:01 (n=106; HR 1.98, p 〈 .001; HR 1.53, p=.001). HLA-DPB1*04:02 was the only allele associated with an increased risk of grade II-IV aGVHD in the FM group (n=173; HR 1.64; p=.001). HLA-DPB1*04:02 was linked to two distinctive extended HPs, and the effect of these HPs on aGVHD was stronger in the patients with HLA-DRB1*04:05-DQB1*04:01-DPB1*04:02 (n=60; HR 2.15; p 〈 .001) than in those with HLA-DRB1*01:01-DQB1*05:01-DPB1*-DPB1*04:02 (n=125; HR 1.40; p=.035). HLA-DRB1*04:05-DQB1*04:01-DPB1*04:02 was also significantly associated with poor OS in the FM group (HR 1.65; p=.01). HP-P2 showed a tendency to reduce the risk of grade II-IV aGVHD in the FM group (n=119; HR 0.70; p=.075). Conclusion Patient- and donor-specific HLA alleles and HPs themselves contribute to the risk of aGVHD and survival after UR-HSCT. In addition to HLA-B*51:01 being strongly associated with Bechet’s disease, we found this allele to be associated with an increased risk of aGVHD in UR-HSCT. Given that different HLA alleles and HPs were identified in the FM and MM groups, multiple mechanisms, including HLA-mismatch induced alloreactivity, might be involved in the development or exacerbation of aGVHD. These findings suggest that, in addition to HLA-matching status, consideration of patient and donor HLA alleles and haplotypes will provide predictive risk factors for UR-HSCT. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
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  • 6
    In: Blood, American Society of Hematology, Vol. 116, No. 15 ( 2010-10-14), p. 2839-2846
    Abstract: The majority of cord blood transplantations (CBTs) have human leukocyte antigen (HLA) disparities. We investigated the impact that patients' pretransplantation anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody and its specificity was performed retrospectively at the Japanese Red Cross Tokyo Blood Center with sensitive solid-phase antibody detection assays. Among 386 CBTs, which were first myeloablative stem cell transplantations for malignancies and used a single unit of cord blood, 89 tested positive. Among the antibody-positive group, the cord blood did not have the corresponding HLA type for the antibody in 69 cases (ab-positive), while 20 cases had specificity against the cord blood HLA (positive-vs-CB). Cumulative incidence of neutrophil recovery 60 days after transplantation was 83% (95% confidence interval [CI], 79%-87%) for the antibody-negative group (ab-negative), 73% (95% CI, 61%-82%) for ab-positive, but only 32% (95% CI, 13%-53%) for the positive-vs-CB (P 〈 .0001, Gray test). With multivariate analysis, the ab-positive showed significantly lower neutrophil recovery than the ab-negative (relative risk [RR] = 0.69, 95% CI, 0.49-0.96, p = .027). The positive-vs-CB had significantly lower neutrophil recovery (RR = 0.23, 95% CI, 0.09-0.56, P = .001) and platelet recovery (RR = 0.31, 95% CI, 0.12-0.81, P = .017) than the ab-negative. Patients' pretransplantation anti-HLA antibodies should be tested and considered in the selection of cord blood.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
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  • 7
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 59-59
    Abstract: [INTRODUCTION] Although the effect of HLA locus and/or HLA antigen matching on clinical outcome of unrelated bone marrow transplantation (UR-BMT) has been well characterized, the effect of HLA haplotype (HP) itself is little known. The large scale genotyping of HLA-A, B, C, DRB1, DQB1, DPB1 alleles and SNPs among HLA region by whole genome association scans (WGAS) made it possible to ellucidate conserved common HPs and their impact to acute GVHD in HLA allele matched Japanese patient-donor pairs through Japan Marrow Donor Program. [PATIENTS AND METHODS] 5210 patients who received T cell replete marrow were retrospectively typed for HLA-A, B, C, DRB1, DQB1 and DPB1 allele, and 1810 pairs performed WGAS using Affimetrics 500k array. HLA allele fullmatch was found in 712 pairs, of whom 451 pairs were genotyped 912 SNPs between HLA-A and HLA-DPB2 (from nucleotide 29989443 to 33205942, 3.2Mb). 45 common HLA-A, B, C, DRB1, DQB1, DPB1 HPs among Japanese (designated as HP-P1 to HP-P45) was determined according to the combination of HLA alleles. The probabilities of acute GVHD (grade 2–4) were estimated using the cumulative incidence function, where death without acute GVHD was regarded as a competing risk. Hazard risk (HR) of grade 2–4 acute GVHD was assesed by multivariable Cox regression analysis adjusting with 8 clincal factors. [RESULTS] 1) 220 pairs determined both HPs, 354 one HP, 64 no HP and 74 HP with ambiguility of HP. There was no difference of acute GVHD between these 4 groups (26.7%, 33.2%, 28.6%, 35.8%, respectively). And that, donor and recipient mismatching rate of SNPs was not associated with acute GVHD; less than 5 mismatch SNPs (n=126) showed 32.2%, 6–50 (n=105) 32.4%, 51–100 (n=102) 27.5%, and more than 101 (n=118) 31.4%. 2) Most frequent HP (HP-P1: HLA- A*2402- Cw*1202- B*5201- DRB1*1502- DQB1*0601- DPB1*0901) was found in 331 pairs, and the second HP (HP-P2: HLA-A*3303- Cw*1403- B*4403- DRB1*1302- DQB1* 0604- DPB1*0401) in 111 pairs. 68 out of 72 homozygous HP-P1/P1 individuals had identical homozygous alleles for more than 98% of 912 consecutive SNPs. Of 10 HP-P2/P2 homozygous individuals, all individuals were identical homozygous alleles for 99% of 1310 consecutive SNPs extending from nucleotide 29001906 to 33987897 (4.9 Mb). Further more, 32 out of 34 heterozygous HP-P1/P2 individuals had more than 99% identical consecutive 912 alleles. 3) Considerable number of pairs with HP-P1 made it possible to compare another HPs for the risk of acute GVHD. Notably, 16.2% of acute GVHD in homozygous HP-P1/P1 pair (n=33) and 12.0% of acute GVHD in HP-P1/P2 pair (n=25) were significaitly lower than 39.1% in pair with HP-P1 and HP-P3-45 (n=246) (p=0.01), and HR was 0.41 (p=0.04) and 0.30 (p=0.04) respectively. 4) When analyzed an individual HP, patients with HP-P2 showed significant lower incidence of acute GVHD (22.3% n=111) than HP-P2 negative one (32.7% n=601) (p=0.031), and HR was 0.63 (p=0.032), and the other HPs did no significant difference. [CONCLUSIONS] Donor and recipient mismatching rate of SNPs in HLA region had no correlation with acute GVHD in HLA full matched UR-BMT in JMDP. Common HP-P1 and HP-P2 were highly conserved through HLA-A to HLA-DPB2. Patients with HP-P1/P1 and those with HP-P1/P2 showed lower incidence of acute GVHD, which is compatible with BMT from HLA identical sibling among Japanese. Specific HP (HP-P2)itself reduced the incidence of acute GVHD. These results contribute to favorable outcome of UR-BMT and to ellucidate the mechanism of acute GVHD.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
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