Response to immunosuppressive therapy and an HLA-DRB1 allele in patients with aplastic anaemia: HLA-DRB1*1501 does not predict response to antithymocyte globulin

Br J Haematol. 1996 Jan;92(1):155-8. doi: 10.1046/j.1365-2141.1996.293825.x.

Abstract

HLA-DRB1*1501, a subtype of HLA-DR2, has been shown to be closely associated with a good response to cyclosporine (CyA) therapy in patients with aplastic anaemia (AA). To determine whether this DRB1 allele can also predict a response to antithymocyte globulin (ATG) therapy in AA patients, we analysed the results of HLA-DRB1 typing in 59 Japanese patients who received ATG within 2 years after diagnosis of AA and also in 52 patients treated with CyA. All patients were divided into three groups: those with DRB1*1501, those with DRB1*1502, and those without either of these two alleles (DR2-). The response rate to ATG in DRB1*1501+ patients (56%) was not significantly higher than that in DRB1*1502+ patients (47%) and in the other DR2- patients (54%). In contrast, the response rate to CyA therapy in DRB1*1501+ patients (92%) was significantly higher than that in the DRB1*1502+ (41%) and in DR2- patients (57%). Multivariate analysis revealed that possessing DRB1*1501 was an independent factor significantly predictive of a good response to CyA. These results indicate that although identifying the DRB1*1501 allele in AA patients prior to therapy is predictive of a good response to CyA therapy, it does not have a predictive value for ATG therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alleles
  • Anemia, Aplastic / genetics*
  • Anemia, Aplastic / therapy
  • Antilymphocyte Serum / therapeutic use*
  • Child
  • Child, Preschool
  • Cyclosporine / therapeutic use
  • Female
  • HLA-DR Antigens / analysis*
  • HLA-DRB1 Chains
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Retrospective Studies
  • T-Lymphocytes / immunology
  • Treatment Outcome

Substances

  • Antilymphocyte Serum
  • HLA-DR Antigens
  • HLA-DRB1 Chains
  • Cyclosporine