Histocompatibility

Eric Spierings; Alejandro Madrigal; Katharina Fleischhauer

doi:10.1007/978-3-031-44080-9_9

Histocompatibility

Eric Spierings^*, Alejandro Madrigal, Katharina Fleischhauer

^*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceeding › Chapter › Academic › peer-review

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Abstract

Human leukocyte antigen (HLA) molecules are the most important histocompatibility antigens, due to their genetic polymorphism and their key role in peptide antigen presentation and T-cell alloreactivity. While full matching for the most relevant HLA loci had been regarded as a prerequisite for successful transplantation until recently, the introduction of posttransplant cyclophosphamide (PTCy) as immune prophylaxis has also allowed successful transplantation across multiple HLA mismatches, thus also enabling access to transplantation for patients without a fully compatible donor. The rules governing high-risk/nonpermissive HLA mismatches, identified in the past as immunopeptidome overlaps, expression levels, and predicted indirectly recognized HLA epitopes (PIRCHEs), will have to be redefined in the PTCy area to further improve patient outcomes.

Original language	English
Title of host publication	The EBMT Handbook
Subtitle of host publication	Hematopoietic Cell Transplantation and Cellular Therapies
Publisher	Springer
Pages	73-84
Number of pages	12
ISBN (Electronic)	9783031440809
ISBN (Print)	9783031440793
DOIs	https://doi.org/10.1007/978-3-031-44080-9_9
Publication status	Published - 11 Apr 2024

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AU - Fleischhauer, Katharina

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AB - Human leukocyte antigen (HLA) molecules are the most important histocompatibility antigens, due to their genetic polymorphism and their key role in peptide antigen presentation and T-cell alloreactivity. While full matching for the most relevant HLA loci had been regarded as a prerequisite for successful transplantation until recently, the introduction of posttransplant cyclophosphamide (PTCy) as immune prophylaxis has also allowed successful transplantation across multiple HLA mismatches, thus also enabling access to transplantation for patients without a fully compatible donor. The rules governing high-risk/nonpermissive HLA mismatches, identified in the past as immunopeptidome overlaps, expression levels, and predicted indirectly recognized HLA epitopes (PIRCHEs), will have to be redefined in the PTCy area to further improve patient outcomes.

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Histocompatibility

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