HLA Class III Variant rs915654 Predicts Survival in Haploidentical Transplantation

Allogeneic hematopoietic stem cell transplantation remains the primary curative intervention for high-risk hematologic malignancies, yet its success is frequently limited by the availability of human leukocyte antigen (HLA) matched donors [1, 2]. Haploidentical related donors have emerged as a vital alternative, offering outcomes comparable to matched unrelated donors while significantly expanding the donor pool [3, 4]. Despite advances in graft-versus-host disease prophylaxis and conditioning regimens, clinicians still face substantial challenges with post-transplant relapse and non-relapse mortality [5, 6]. Current donor selection algorithms primarily focus on HLA class I and II loci, but these markers do not fully account for the varied immune responses observed in clinical practice [7]. A new study now investigates how extending genetic analysis to include the HLA class III region, a segment of the major histocompatibility complex containing genes involved in the inflammatory response, may provide a more precise tool for predicting transplant success.