The impact of donor and recipient MDR1 G2677TA, C1236T, C3435T match and mismatch on the outcomes of patients after allogeneic hematopoietic stem cell transplantation

Abstract In this study, we investigated whether the matched or mismatched multidrug resistance (MDR1) G2677TA, C1236T and C3435T were associated with prognosis in patients after allo-HSCT. One hundred patients after transplantation and their donors were enrolled. We tested all enrollers for genotypes at the following three loci: G2677TA, C1236T and C3435T. Matched MDR1 G2677TA donor-recipient was associated with an increased risk of non-relapse mortality (NRM) (29.5% vs. 6.2%, p = 0.002), and poor overall survival (OS) (51.7% vs. 63.8%, p = 0.024) and disease-free survival (DFS) (38.6% vs. 67%, p = 0.005). There were no differences in OS, DFS, NRM between MDR1 C1236T, C3435T matched and mismatched group. Subgroup analysis suggested that in matched MDR1 G2677TA group, male (OS, 31.3% vs. 76.9%, p = 0.011; DFS, 25% vs. 55.6%, p = 0.027), hematopoietic cell transplantation–specific comorbidity index (HCT-CI) ≥ 1 (OS, 16.7% vs. 60.9%, p = 0.007; DFS, 16.7 vs. 44.4%, p = 0.017), acute kidney injury (AKI) patients with serum creatinine > 137.2umol/L (OS, 12.5% vs. 80%, p = 0.047; DFS, 0 vs. 60%, p = 0.017), and post-transplantation thrombocytopenia (PT) (OS, 33.3% vs. 71.4%, p = 0.030; DFS, 21.4% vs. 55.1%, p = 0.018 ) had poor survival. Results demonstrated that prognosis of matched MDR1 G2677TA donor-recipient was worse than mismatched. It may become a useful molecular tool to identify the poor prognosis of patients after transplantation.