ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1562869
Analyzing the impact of Human Leukocyte Antigen (HLA) mismatch on the incidence of prostate cancer and the advantage of T cell therapy in patients after kidney transplantation based on the United Network for Organ Sharing (UNOS) database
Provisionally accepted
- 1Shanghai Changzheng Hospital, Huangpu, China
- 2Shanghai 455 Hospital, Shanghai, Shanghai Municipality, China
- 3Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, Beijing, China
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Background We aim to analysis the impact of Human Leukocyte Antigen (HLA) mismatch between kidney transplant donors and recipients on the incidence of prostate cancer after kidney transplantation (KT). Meanwhile, understanding the use of T cell therapy is of great importance after kidney transplantation from the perspective of prostate cancer occurrence.A retrospective study was conducted on kidney transplant recipients based on the United Network for Organ Sharing (UNOS) database from 2000 to 2019. General demographic data, socio-economic and educational data, personal medical history, immunosuppressive therapy regimens, and HLA typing of donors and recipients were collected to analyze the impact of: (1) baseline patient characteristics; (2) HLA mismatch; and (3) HLA subtype mismatch on the incidence of prostate cancer after transplantation. Results A total of 268 994 kidney transplant recipients were included, with 1 910 newly diagnosed prostate cancer patients after surgery. Both univariate and Cox multivariate analysis discovered that the use of T cell therapy could reduce the risk of prostate cancer after KT [0.89(0.86~0.91)]. We also found HLA mismatch ≥ 3 is a risk factor of prostate cancer after transplantation [1.07(1.02~1.11)]. Further subgroup analysis was conducted on HLA mismatch. The Cox multivariate analysis of HLA-A (0-2), HLA-B (0-2), and HLA-DR (0-2) mismatch showed that 2-mismatch in HLA-A and HLA-B was a risk factor of prostate cancer after KT [1.19(1.01~1.40)]; 2-mismatch and 1mismatch were both risk factors of prostate cancer after KT in the HLA-DR group [1.32(1.13~1.54)], [1.20(1.03~1.39)].Conclusions From the perspective of prostate cancer occurrence after transplantation, the use of T cell therapy is of great significance. HLA mismatch ≥ 3 was a risk factor of prostate cancer after KT. HLA-A and HLA-B 2-mismatch were risk factors of prostate cancer after KT, while HLA-DR 1-mismatch and 2-mismatch were both risk factors of prostate cancer after KT. This research contributed to the focus on the relationship between induction therapy and cancer occurrence after KT, and also provide guidance for reasonable selections of HLA typing of prostate cancer before KT.
Keywords: KT, HLA typing, prostate cancer, UNOS, Induction therapy
Received: 18 Jan 2025; Accepted: 21 Aug 2025.
Copyright: © 2025 Gao, Monica, Mao, Jiang, Guo and Fu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shangxi Fu, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, Beijing, China
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