Abstract
BACKGROUND: Obstructive airways disease (OAD) is a known complication of allogeneic bone marrow transplantation. The etiology of OAD is unknown but is probably multifactorial. The identification of a significant human lymphocyte antigen (HLA) association with the development of OAD might offer some insight into its pathogenesis and serve as a marker to identify prospectively patients at risk for developing OAD.OBJECTIVE: The major histocompatibility antigen (MHC) associations of OAD post-allogeneic bone marrow transplantation were studied to determine whether particular subsets of patients are more susceptible to this syndrome.POPULATION: Twenty-one of 244 consecutive patients with allogeneic transplants performed between 1980 and 1987 were identified as developing OAD after having had normal pulmonary function tests before transplant. Thirty-nine controls were selected on the basis of normal pulmonary function tests pre- and post-transplant and comparable follow-up periods.METHODS: The study was a retrospective case-control study. Gene frequencies of the HLA-A and -B types in the patients and controls were compared and a relative risk of OAD with a given HLA allele was calculated.RESULTS: There was a significant correlation of the development of OAD with the presence of the MHC antigen, HLA-B12 (44,45).CONCLUSIONS: These data support the idea that patients who express the HLA-B12 (44,45) antigen are at higher risk for the development of OAD post bone marrow transplantation. However, the findings are based on retrospective analysis and accordingly should be considered tentative until followed by larger and preferably prospective studies to confirm the findings.