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              <classCode scheme="mesh">Adolescent</classCode>
              <classCode scheme="mesh">Adult</classCode>
              <classCode scheme="mesh">Hematologic Neoplasms</classCode>
              <classCode scheme="mesh">Humans</classCode>
              <classCode scheme="mesh">Immunosuppressive Agents</classCode>
              <classCode scheme="mesh">Interferon-gamma</classCode>
              <classCode scheme="mesh">Male</classCode>
              <classCode scheme="mesh">Middle Aged</classCode>
              <classCode scheme="mesh">Minor Histocompatibility Antigens</classCode>
              <classCode scheme="mesh">Peripheral Blood Stem Cell Transplantation</classCode>
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              <classCode scheme="mesh">T-Lymphocyte Subsets</classCode>
              <classCode scheme="mesh">Bone Marrow Transplantation</classCode>
              <classCode scheme="mesh">Tissue Donors</classCode>
              <classCode scheme="mesh">Transplantation</classCode>
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              <classCode scheme="mesh">CD8-Positive T-Lymphocytes</classCode>
              <classCode scheme="mesh">Enzyme-Linked Immunosorbent Assay</classCode>
              <classCode scheme="mesh">Feasibility Studies</classCode>
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              <classCode scheme="mesh">Follow-Up Studies</classCode>
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              <p>BACKGROUND: After HLA-identical hematopoietic stem cell transplantation, minor histocompatibility (mH) antigen alloreactivity plays a dominant role in the development of graft-versus-host disease (GVHD) and graft versus leukemia (GVL). STUDY DESIGN AND METHODS: We have analyzed the mH alloreactivity (enzyme-linked immunospot [ELISpot] for interferon-gamma[IFN-gamma] assay) from 24 donor/recipient pairs over a period of 2 years of follow-up and correlated such alloreactivity with the development of GVHD or absence of relapse. Circulating specific T cells anti-mH with multimer HLA-peptides were also studied. RESULTS: We show by ELISpot IFN-gamma assay that alloreactivity during the first 3 months from donor versus recipient or donor versus mismatched identified mH antigens is associated with acute GVHD and GVL effect. In addition, we demonstrate that the donor-versus-recipient reactivity observed after the third month is highly associated with chronic GVHD and GVL (p = 0.0007). Finally, we show by multimer HLA-peptide assay that mH epitope-specific T cells present after 3 months are statistically related to the GVL effect. CONCLUSIONS: Our results provide a robust method to monitor mH antigen graft-versus-host reaction and suggest that current identified mH have predictive value on GVHD and GVL.</p>
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