Individual HLAs influence immunological events in allogeneic stem cell transplantation from HLA-identical sibling donors. Bone Marrow Transplant.
Individual HLAs influence immunological events in allogeneic stem cell transplantation from HLA-identical sibling donors. Bone Marrow Transplant.
复制标题
个体 HLA 会影响来自 HLA 相同兄弟供体的同种异体干细胞移植中的免疫学事件。
DOI：
10.1038/s41409-020-01070-3
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Morishima Y.
中科院分区：
文献类型：
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作者：
Morishima S;Fukuda T;Doki N;Mori T;Onizuka M;Kawakita T;Kato C;Ozawa Y;Tanaka M;Kurokawa M;Kamimura T;Inoue M;Tanaka J;Ichinohe T;Atsuta Y;Morishima Y.
在异基因造血干细胞移植（allo-HSCT）中，患者和供体人类白细胞抗原（HLA）匹配状态对移植物抗宿主病（GVHD）的影响已被广泛阐明，但特异性HLA对急性GVHD的影响仍不清楚。利用日本登记处的数据，我们回顾性分析了4392例白血病或骨髓增生异常综合征患者，这些患者接受了来自HLA相同同胞供体的移植，以研究HLA对急性GVHD的影响。通过对HLA-A、-B和-DR的公正搜索，HLA-B 60与II-IV级急性GVHD的风险增加显着相关（HR，1.34; 95%CI，1.13-1.59;P= 0.001）。相反，HLA-B62与II-IV级（HR，0.73; 95%CI，0.62-0.87;P< 0.001）和III-IV级急性GVHD（HR，0.63; 95%CI，0.46-0.87;P= 0.005）的风险降低显著相关。HLA-B62阳性患者的白血病复发风险显著高于HLA-B62阴性患者（HR，1.23; 95%CI，1.05-1.43;P= 0.01）。HLA-B60和-B62均不影响总生存率。这项研究的结果可能暗示特定HLA对移植结果的影响可能反映了固有的生物学特征，因此考虑特定HLA可能有助于预测移植结果。
In allogeneic hematopoietic stem cell transplantation (allo-HSCT), the effects of patient and donor human leukocyte antigen (HLA) matching status on graft-versus-host disease (GVHD) have been extensively elucidated, but the effects of specific HLAs on acute GVHD remain unclear. Using data from a Japanese registry, we retrospectively analyzed 4392 patients with leukemia or myelodysplastic syndrome who received transplants from HLA-identical sibling donors to investigate the effects of HLAs on acute GVHD. From unbiased searches of HLA-A, -B, and -DR, HLA-B60 was significantly associated with an increased risk of grades II–IV acute GVHD (HR, 1.34; 95% CI, 1.13–1.59;P= 0.001). In contrast, HLA-B62 was significantly associated with a decreased risk of grades II–IV (HR, 0.73; 95% CI, 0.62–0.87;P< 0.001) and III–IV acute GVHD (HR, 0.63; 95% CI, 0.46–0.87;P= 0.005). The risk of leukemia relapse was significantly higher in HLA-B62-positive patients than in HLA-B62-negative patients (HR, 1.23; 95% CI, 1.05–1.43;P= 0.01). Both HLA-B60 and -B62 did not affect overall survival. The findings of this study may by implication suggest the possibility that the effects of specific HLAs on transplant outcomes may reflect inherent biological features, and thus consideration of specific HLAs may be helpful to predict transplant outcomes.