Minor histocompatibility antigens (mHA) are peptides derived from normal cellular proteins presented by major histocompatibility complex (MHC) class I and class II molecules. Following allogeneic hematopoietic stem cell transplantation (HSCT), recipient mHA are recognized by donor T cells and become the primary targets of graft-vs-host disease (GVHD). To the extent that mHA are expressed on leukemia cells, these antigens also become important targets of graft-vs-leukemia (GVL) following HSCT. Several well-defined mHA are encoded by genes on the Y chromosome, and CD4+ and CD8+ T cell responses to HY antigens following allogeneic HSCT can mediate GVHD and GVL. Using HY proteins as a model for human mHA, previous laboratory studies in this project demonstrated that male patients engrafted with stem cells from female donors frequently develop antibodies that recognize Y-encoded proteins after transplant. HY antibodies typically develop 4-8 months after transplant and do not occur in patients who receive stem cells from gender-matched donors. HY antibodies persist at high titer for prolonged periods and are significantly associated with the development of chronic GVHD. In studies described in Project 1, these observations led to the evaluation of B cell directed therapy with rituximab for patients with steroid resistant chronic GVHD with promising clinical results. Although these observations suggest that antibodies specific for mHA play a role in chronic GVHD, the mechanisms whereby HY antibodies contribute to tissue damage in affected organs have not been elucidated. To better define the role of B cells and antibodies in the pathogenesis of chronic GVHD, proposed studies in Project 3 will develop new genomic and proteomic approaches to define the spectrum of antibody targets in patients with chronic GVHD and to identify clinically relevant new mHA. Proposed studies will also examine B Cell Activating Factor (BAFF) as a potential biologically relevant marker of chronic GVHD and define the mechanisms whereby B cells and antibodies interact with T cells and contribute to GVHD and GVL following HSCT. There are 4 Specific Aims in Project 3. 1 .Define the spectrum of B cell target antigens in patients with chronic GVHD. 2. Identify novel mHA through genomic comparisons of HLA-identical recipients and donors. 3. Determine whether soluble BAFF levels accurately predict the development of chronic GVHD. 4. Define the mechanisms whereby B cells and antibodies contribute to the development of tissue damage following allogeneic HSCT.

Public Health Relevance

Acute and chronic GVHD result from recognition of recipient cells by donor immune cells after allogeneic HSCT. Although GVHD occurs frequently and leads to substantial toxicity, few specific antigenic targets have been identified. Previous studies in this project demonstrated that both donor B cells and T cells contribute to chronic GVHD. Studies proposed in this project will develop new methods to identify specific targets of donor B and T cells and will determine how these cells cooperate to cause tissue injury.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Program Projects (P01)
Project #
Application #
Study Section
Heart, Lung, and Blood Initial Review Group (HLBP)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Dana-Farber Cancer Institute
United States
Zip Code
Bachireddy, Pavan; Hainz, Ursula; Rooney, Michael et al. (2014) Reversal of in situ T-cell exhaustion during effective human antileukemia responses to donor lymphocyte infusion. Blood 123:1412-21
Dubovsky, Jason A; Flynn, Ryan; Du, Jing et al. (2014) Ibrutinib treatment ameliorates murine chronic graft-versus-host disease. J Clin Invest 124:4867-76
Koreth, John; Kim, Haesook T; Nikiforow, Sarah et al. (2014) Donor chimerism early after reduced-intensity conditioning hematopoietic stem cell transplantation predicts relapse and survival. Biol Blood Marrow Transplant 20:1516-21
Herrera, Alex F; Kim, Haesook T; Bindra, Bhavjot et al. (2014) A phase II study of bortezomib plus prednisone for initial therapy of chronic graft-versus-host disease. Biol Blood Marrow Transplant 20:1737-43
Gazourian, Lee; Rogers, Angela J; Ibanga, Ruby et al. (2014) Factors associated with bronchiolitis obliterans syndrome and chronic graft-versus-host disease after allogeneic hematopoietic cell transplantation. Am J Hematol 89:404-9
Socié, Gérard; Ritz, Jerome (2014) Current issues in chronic graft-versus-host disease. Blood 124:374-84
Armand, Philippe; Kim, Haesook T; Virtanen, Johanna M et al. (2014) Iron overload in allogeneic hematopoietic cell transplantation outcome: a meta-analysis. Biol Blood Marrow Transplant 20:1248-51
Alexander, Kylie A; Flynn, Ryan; Lineburg, Katie E et al. (2014) CSF-1-dependant donor-derived macrophages mediate chronic graft-versus-host disease. J Clin Invest 124:4266-80
Kim, Haesook T; Frederick, David; Armand, Philippe et al. (2014) White blood cell recovery after allogeneic hematopoietic cell transplantation predicts clinical outcome. Am J Hematol 89:591-7
Pai, Chien-Chun Steven; Chen, Mingyi; Mirsoian, Annie et al. (2014) Treatment of chronic graft-versus-host disease with bortezomib. Blood 124:1677-88

Showing the most recent 10 out of 68 publications