Donor Immunization Against Human Leukocyte Class II Antigens is a Risk Factor for Graft-versus-Host Disease Florent Delbos, Walid Barhoumi, Ludovic Cabanne,

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Donor Immunization Against Human Leukocyte Class II Antigens is a Risk Factor for Graft-versus-Host Disease Florent Delbos, Walid Barhoumi, Ludovic Cabanne, Florence Beckerich, Christine Robin, Rabah Redjoul, Safae Astati, Andréa Toma, Cécile Pautas, Hélène Ansart-Pirenne, Catherine Cordonnier, Philippe Bierling, Sébastien Maury Biology of Blood and Marrow Transplantation Volume 22, Issue 2, Pages 292-299 (February 2016) DOI: 10.1016/j.bbmt.2015.09.027 Copyright © 2016 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Luminex representation of HLA class II antibody screening (A) and SA assay (B) for a serum sample. An NBG ratio >3 for at least 1 of the 5 multiantigen screen beads was associated with positive detection of anti-HLA class II antibodies. Each bead was coated with 18 to 23 different HLA antigens. The identified HLA specificities corresponded to the HLA antigen coated in each SA bead with an MFI >500. Only some of the 97 SA class II beads are represented here. Biology of Blood and Marrow Transplantation 2016 22, 292-299DOI: (10.1016/j.bbmt.2015.09.027) Copyright © 2016 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Female donors have higher levels of anti-HLA class II immunization than male donors. Each point depicts the mean NBG ratio of 5 HLA class II screening beads for each of the 11 female (F) and 15 male (M) donors. Mean value for female and male donors are depicted by horizontal bars. Comparing median values, female donors also had a higher NBG ratio than male donors (2.39 versus 1.36; P = .02, Mann-Whitney U test). Biology of Blood and Marrow Transplantation 2016 22, 292-299DOI: (10.1016/j.bbmt.2015.09.027) Copyright © 2016 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Cumulative incidence of acute GVHD (A), chronic GVHD (B), and first episode of either acute or chronic GVHD (C) according to the presence of at least 1 anti-HLA class II antibody in the donor (dashed line) or not (solid line). Only cases reported as acute or late acute, grade II to IV, or chronic extensive forms and requiring a systemic immunosuppressive therapy were taken into account. Biology of Blood and Marrow Transplantation 2016 22, 292-299DOI: (10.1016/j.bbmt.2015.09.027) Copyright © 2016 American Society for Blood and Marrow Transplantation Terms and Conditions