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Differences in Human Leukocyte Antigen Expression Between Breast Implant-Associated ALCL Patients and the General Population.

Aesthetic Surgery Journal 2019 Februrary 4
Background: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T-cell lymphoma associated with textured-surface breast implants. Human leukocyte antigen (HLA) polymorphisms have been described with other forms of lymphoma, but have not been described for BIA-ALCL.

Objectives: The aim of this study was to evaluate HLA polymorphisms in BIA-ALCL patients.

Methods: We prospectively evaluated HLA alleles in patients with BIA-ALCL. HLA testing was performed using probe-based sequence specific testing and sequence-based typing. The frequency of HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 were evaluated. Allele frequencies in the Caucasian European general population were obtained from the National Marrow Donor Program for normative controls. We estimated the relative risk of breast implant ALCL with 95% confidence intervals using a t test.

Results: Thirteen patients with BIA-ALCL and HLA testing were identified from 2017-2018. Patients carried 10, 11, and 9 HLA A, B, and C alleles respectively. There were 8 DRB1 alleles and 5 DQB1 alleles in the BIA-ALCL patients. The A*26 allele occurred significantly more frequently in the general population compared with BIA-ALCL patients (0.2992 vs. 0.07692, p<0.001).

Conclusions: Our results identify a difference in HLA A*26 in patients who develop BIA-ALCL compared with the general population and may signify genetic susceptibility factors for germline genetic variation in HLA in patients with BIA-ALCL. Further work is needed to elucidate if these alleles are predictive for BIA-ALCL in women with textured-surface breast implants.

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