HLA‐DRB1 and cytokine polymorphisms in Brazilian patients with myelodysplastic syndromes and its association with red blood cell alloimmunization

Objective(s) This study aimed investigate association of HLA‐DRB1 and cytokine polymorphisms with red blood cell(RBC) alloimmunization in Brazilian Myelodysplastic syndrome(MDS) patients with prior exposure to RBC transfusion. Background MDS patients are at risk RBC alloimmunization due to chronic R...

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Bibliographic Details
Published in:	Transfusion medicine (Oxford, England) Vol. 32; no. 5; pp. 394 - 401
Main Authors:	Sirianni, Marilia Fernandes Mascarenhas, Sippert, Emilia, Blos, Bruna, Gonçalves, Flavia Ricioli Vaz, Hamerschlak, Nelson, Kutner, Jose, Castilho, Lilian, Marti, Luciana Carvalheiro, Bonet‐Bub, Carolina
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-10-2022
Subjects:	alloimmunization blood groups cytokine polymorphisms HLA polymorphisms HLA‐antigens myelodysplastic syndromes
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Summary:	Objective(s) This study aimed investigate association of HLA‐DRB1 and cytokine polymorphisms with red blood cell(RBC) alloimmunization in Brazilian Myelodysplastic syndrome(MDS) patients with prior exposure to RBC transfusion. Background MDS patients are at risk RBC alloimmunization due to chronic RBC transfusion. However, differences in immune response of MDS transfused patients are not completely known. Methods/materials A retrospective cohort of 87 polytransfused patients with MDS including 28 alloimmunized (PA) and 59 non‐alloimmunized (PNA) was evaluated in three Brazilian reference hospitals. HLA‐DRB1genotype was performed by polymerase chain reaction (PCR)‐SSOP (Luminex platform) and cytokine polymorphisms analysed by PCR and TaqMan assays. Results While HLA‐DRB1 allele frequencies did not differ between groups, IL17A 197G > A SNP and IL4 polymorphisms showed significant correlation with RBC alloimmunization. IL17A 197A allele A and AA genotype were significantly more frequent in PA than PNA(A, 46.4% versus 27.1%, p = 0.012; OR = 2.3; 95%CI = 1.1–4.9; AA, 25% versus 6.8%, p = 0.041; OR = 6.2; 95%CI 1.3–30.8). Moreover, significant association of alloimmunization to Rh antigens with IL17A 197A allele and AA genotype was also identified in PA group(A, 45% versus 27.1%, p = 0.036; OR = 2.5; 95% CI 1.1–5.7; AA, 30% versus 6.8%, p = 0.042; OR = 7.9; 95%CI 1.5–42.3). Genotype A1A2 of IL4 intron 3 was overrepresented in PA(50% versus 16.9%, p = 0.009; OR = 4.97; 95%CI 1.6–15.5). Similarly, IL4–590 CT genotype was overrepresented in PA(53.6% versus 28.8%, p = 0.049; OR = 3.3; 95%CI 1.2–9.3). Conclusions This study showed no association regarding HLA‐DRB1 alleles for RBC alloimmunization risk or protection, however the IL17A 197G>A, IL4 intron 3 and IL4 590C>T SNP was significantly associated to RBC alloimmunization risk in this cohort of Brazilian MDS patients.
Bibliography:	Funding information Fundação de Amparo à Pesquisa do Estado de São Paulo, Grant/Award Number: 2018/16451–5 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0958-7578 1365-3148
DOI:	10.1111/tme.12894