在血造细胞移植后的HLA杂型和复发
Effie W Petersdorf1,2, Caroline McKallor3, Mari Malkki1
1Division of Translational Science and Therapeutics, Fred Hutchinson Cancer Center, Seattle, WA.
概括
通过考虑人类白细胞抗原 (HLA) II 类单体类型,可以提高血造细胞移植的成功率. 患者和捐赠者的特定HLA变异影响复发风险和整体移植结果.
科学领域:
- 免疫遗传学 免疫遗传学
- 移植免疫学 移植免疫学
背景情况:
- 复发性血液恶性瘤是血液细胞移植 (HCT) 失败的主要原因.
- 人类白细胞抗原 (HLA) 类II分子对于抗瘤反应至关重要,但它们在HCT中所扮演的角色尚不清楚.
研究的目的:
- 为了研究单个HLAII类分子和相关的 haploidentical HCT. haplotypes的临床意义.
- 确定HLAII类单元类型是否影响移植结果,特别是复发和死亡率.
主要方法:
- 在1,629个相关的单一移植中分析HLA-DR, -DQ, -DM和 -DO等位基因变异.
- 特定HLA变异和单元型与患者和捐赠者因素和临床结果的相关性.
主要成果:
- 在HLA-DRβ残留86,HLA-DQ异构体 (G1/G2) 和供体HLA-DM分子中的患者和供体变异与移植结果有显著的相关性.
- 特定的HLA-DRβ-86基因型 (GlyGly/GlyVal) 和HLA-DQ (G1G2) 不匹配与较低的复发风险有关.
- 与ArgArg相比,捐赠者HLA-DMα残留物184 (ArgHis) 与更高的复发风险有关.
- 在各种HLA-DR-DQ-DM单元型中观察到复发和死亡风险的显著差异.
结论:
- 第二类HLA单元类型可以作为移植屏障的关键组成部分.
- 将HLAII类哈普洛型匹配纳入患者和供体选择可以提高HCT的成功率.
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