IFNL4 and donor selection for matched unrelated donor haematopoietic stem-cell transplantation
Menée aux Etats-Unis à partir de données portant sur 404 patients atteints d'une leucémie aiguë et ayant reçu une greffe de cellules souches hématopoïétiques issues d'un donneur non apparenté puis validée sur 1 245 patients supplémentaires, cette étude évalue l'association entre le génotype de l'interféron lambda 4 du donneur et du receveur et les résultats de survie après la greffe (mortalité non liée à une récidive, survie globale)
The selection of an optimal donor is an essential element in ensuring the best possible outcome for patients undergoing allogeneic haematopoietic stem-cell transplantation. HLA matching of donors and recipients represented a major milestone contributing substantially to the first successful transplant outcomes. Although the earliest allogeneic transplantations relied primarily on HLA-matched sibling donors, expansion of the donor pool for those without a suitably matched sibling donor soon emerged as an unmet need and led to the establishment of donor registries in the 1980s, which now list in excess of 32 million potential donors worldwide.1
Over the past 20 years, the widespread adoption of high-resolution allele-level HLA typing has led to marked improvements in outcomes following matched unrelated donor transplantation. Notably, the degree of high-resolution HLA match remains the most important donor-specific predictor of matched unrelated donor outcomes, with a roughly 10% decline in overall survival associated with each successive mismatch at HLA-A, HLA-B, HLA-C, and HLA-DRB1 loci, primarily due to increased treatment-related mortality.
The Lancet Haematology , commentaire, 2019