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Malignant melanoma: relationship of the human leukocyte antigen Class II gene DQB1 * 0301 to disease recurrence in American Joint Committee on Cancer Stage I or II
Author(s) -
Lee Jeffrey E.,
Lu Meisheng,
Mansfield Paul F.,
Platsoucas Chris D.,
Reveille John D.,
Ross Merrick I.
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960815)78:4<758::aid-cncr11>3.0.co;2-u
Subject(s) - medicine , hazard ratio , melanoma , human leukocyte antigen , cancer , stage (stratigraphy) , proportional hazards model , oncology , disease , gastroenterology , immunology , antigen , confidence interval , cancer research , paleontology , biology
BACKGROUND Melanoma patients who carry the human leukocyte antigen (HLA) Class II allele DQB1 * 0301 have an increased frequency of metastases at presentation compared with those lacking HLA‐DQB1 * 0301 . This study was designed to determine whether HLA‐DQB1 * 0301 is associated with an increased risk of recurrence in melanoma patients presenting with American Joint Committee on Cancer (AJCC) Stage I or II (localized) disease. METHODS Molecular oligotyping of HLA‐DQ genes was performed for 259 patients with AJCC Stage I or II melanoma. Rate of disease recurrence was determined by retrospective review and prospective follow‐up. Kaplan‐Meier analysis, log rank, and proportional hazard (Cox) comparison were performed. RESULTS Median follow‐up was 24 months. Minimum follow‐up was 6 months. Although HLA‐DQB1 * 0301 ‐positive and ‐negative patients were balanced with regard to standard melanoma prognostic factors (primary tumor thickness, level of invasion, presence of ulceration, anatomic location, and sex), HLA‐DQB1 * 0301 ‐positive patients were more likely to develop locally recurrent, regional, or distant metastatic melanoma during follow‐up (actuarial median disease free survival 48 months [ DQB1 * 0301 ‐positive patients] vs. 97 months [ DQB1 * 0301 ‐negative patients]; log rank P = 0.0002). HLA‐DQB1 * 0301 status, in addition to primary tumor thickness, was an independent prognostic indicator in these patients (Cox multivariate P = 0.02). CONCLUSIONS Patients presenting with localized melanoma who carry HLA‐DQB1 * 0301 are at an increased risk of developing recurrent disease compared with stage‐matched patients who lack this allele. HLA‐DQB1 * 0301 is a genomic marker which independently identifies melanoma patients in whom recurrence is more likely, and is potentially useful in selecting those most likely to benefit from adjuvant therapy. Cancer 1996;78:758‐63.