Donor-recipient incompatibility at CD31-codon 563 is a major risk factor for acute graft-versus-host disease after allogeneic bone marrow transplantation from a human leucocyte antigen-matched donor

Disparities at minor histocompatibility antigens (mHA) are thought to be re sponsible for acute graft-versus-host disease (aGVHD) in patients receiving bone marrow transplantation (BMT) from a human leucocyte antigen (BLA)-mat ched donor. Although some mHA have been identified in humans, their role in aGVHD has not. Patients (n = 150) receiving a BMT from an HLA-matched dono r were investigated for a correlation between aGVHD and donor/recipient inc ompatibility for seven polymorphisms previously proposed for mHA (HA-1, H-Y , CD31-codon 125, CD31-codon 563, HPA-1, HPA-3 and HPA-5). Only mismatch at CD31-codon 563 predicted grade II-IV aGVHD. The risk derived from CD31-cod on 563 mismatch was the same as that derived from the use of bone marrow fr om an un elated donor. We suggest that donor/recipient compatibility at CD3 1-codon 563 should be added to HLA-typing for donor selection and/or adjust ment of aGVHD prophylaxis.