Polymorphisms in TNFA and TNFR2 affect outcome of unrelated bone marrow transplantation

Bone Marrow Transplant. 2002 Apr;29(7):569-75. doi: 10.1038/sj.bmt.1703409.

Abstract

Effects of polymorphisms in TNFA and TNFR2 on the outcome of 462 cases of unrelated bone marrow transplantation (uBMT) were studied retrospectively. Four alleles of TNFA (U01-U04) distinguished by polymorphism in the upstream region, -1031 (T/C), -863 (C/A) and -857 (C/T), and two alleles of TNFR2 (196M/196R) distinguished by polymorphism at codon 196 were determined. Transplantation involving TNFA-U02- and/or U03-positive donors and/or recipients resulted in a higher incidence of graft-versus-host disease (GVHD) of grade III-IV (P < 0.05 for donor type, P < 0.01 for recipient type) and a lower relapse rate than that involving TNFA-U01 homozygous recipients and/or donors (P < 0.025 for donor type, P < 0.01 for recipient type). These results include the HLA mismatching effect due to linkage disequilibirium of TNFA with HLA loci. However, the effects were also observed in HLA-A, -B and -DRB1 allele-matched transplantation. Transplantation from TNFR2-196R-positive donors exhibited a higher incidence of severe GVHD (P < 0.05) and tendency for a lower relapse rate than that from TNFR2-196M homozygous donors. TNFR2-196R of recipient origin had no effect on GVHD but increased the relapse rate (P < 0.025). These results suggest that TNFA and TNFR2 typings are helpful for predicting uBMT outcome and for preventing severe complications at an early stage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anemia, Aplastic / therapy
  • Antigens, CD / genetics*
  • Bone Marrow Transplantation*
  • Codon / genetics
  • Female
  • Genetic Diseases, Inborn / therapy
  • Genotype
  • Graft vs Host Disease / epidemiology
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / genetics*
  • HLA Antigens / genetics
  • HLA Antigens / immunology
  • Hematologic Neoplasms / therapy
  • Histocompatibility
  • Humans
  • Incidence
  • Linkage Disequilibrium
  • Male
  • Polymorphism, Genetic*
  • Proportional Hazards Models
  • Receptors, Tumor Necrosis Factor / genetics*
  • Receptors, Tumor Necrosis Factor, Type II
  • Recurrence
  • Retrospective Studies
  • Transplantation, Homologous*
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / genetics*

Substances

  • Antigens, CD
  • Codon
  • HLA Antigens
  • Receptors, Tumor Necrosis Factor
  • Receptors, Tumor Necrosis Factor, Type II
  • Tumor Necrosis Factor-alpha