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供体白细胞端粒长度成为移植结果的预后因素

Hengwei Wu^1,2,3, Jing Yu^1,2,3, Yang Cao⁴

¹Bone Marrow Transplantation Center of the First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou 310006, China.

Innovation (Cambridge (Mass.))

|March 6, 2026

概括

供体白细胞端粒长度 (LTL) 可以改善用于全原造血干细胞移植 (allo-HSCT) 的供体选择. 较长的捐赠者LTL,特别是在老年捐赠者中,与更好的患者存活率和急性白血病复发率的降低有关.

科学领域:

血液学血液学血液学
免疫学免疫学免疫学
遗传学是一个遗传学.

背景情况:

较年轻的捐赠者通常是偏好的全源造血干细胞移植 (allo-HSCT).
这种偏好可能会限制对需要移植的患者的供体可用性,特别是当只有老年供体可用时.
供体年龄和白细胞端粒长度 (LTL) 是移植结果的关键因素.

研究的目的:

调查是否捐赠白细胞端粒长度 (LTL),结合捐赠者的年龄,可以完善为接受all-HSCT的急性白血病患者的捐赠者选择策略.
评估供体LTL和年龄对移植结果的影响,包括存活率和复发率.

主要方法:

分析了接受allo-HSCT的1,049名急性白血病患者的发现队列.
来自三个额外中心的153名接受者的复制队列被用于验证.
通过定量PCR测量捐助者LTL,并将其分为短 (Q1) 和长 (Q2-Q4) 组. 捐赠者年龄分为<40 (年轻) 和≥40 (年长) 年.

主要成果:

较长的供体LTL与较低的复发累积发病率 (CIR),改善的整体存活率 (OS) 和更好的无复发存活率 (RFS) 相关.
较年长的捐赠者 (≥40岁) 的移植接收者具有较短的LTL,与年轻的捐赠者移植接收者相比,他们的CIR显著更高,OS和RFS更差.
免疫细胞分析表明,具有短LTL的老年捐赠者增加了CD8+CD57+HLA-DR-细胞,这表明受损结果的潜在机制.

结论:

捐赠者LTL是用于all-HSCT的捐赠者评估的宝贵补充因素,特别是当年轻的捐赠者无法获得时.
考虑供体LTL以及供体年龄可以优化供体选择,并改善急性白血病患者的治疗结果.
这种方法可以通过更好地利用可用的捐赠者来提高移植可访问性和成功率.

关键词:

患有急性白血病的人.全源性造血干细胞移植造血干细胞移植供体选择供体选择白细胞端粒的长度是什么

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