Effect of HLA class I or class II incompatibility in pediatric marrow transplantation from unrelated and related donors
Effect of HLA class I or class II incompatibility in pediatric marrow transplantation from unrelated and related donors
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DOI：
10.1016/s0198-8859(01)00220-8
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发表时间：
2001-04-01
期刊：
影响因子：
2.7
通讯作者：
Bowman, LC
中科院分区：
文献类型：
--
作者：
Leung, WH;Turner, V;Bowman, LC
骨髓移植(BMT)中可耐受的组织不相容程度以及个体HLAI和II类基因座匹配的相对重要性尚未确定。我们假设，在选择成功的骨髓移植供者时，匹配HLA-DR MAP并不比匹配HLA-A或HLA-B更重要。我们回顾分析了连续248例接受血缘关系供者(RD，n=119)和非血缘供者(URD，n=129)异基因骨髓移植的儿科患者的结果。在供受者配对中，69%的供受者进行了HLA-A和HLA-B的血清学鉴定，其中有69%的供受者的DNA分型结果与人类白细胞抗原DRB1完全一致。大多数患者(89%)患有恶性血液病；其余患者患有再生障碍性贫血或先天性疾病。1个HLAA抗原不匹配与RD骨髓移植受者存活率下降(P=0.003.0 1)和粒细胞植入延迟(P=0.0 2)，以及URD骨髓受者存活率下降(P=0.0 2)和严重急性移植物抗宿主病(GVHD)的发展(P=0.0 3)有关。一个HLAB抗原不匹配与RD骨髓受者存活率下降(P=0.0007)和发生严重移植物抗宿主病(P=0.0007)有关。一个人类白细胞抗原-DRB1等位基因不匹配只与RD骨髓受者存活率降低有关(p=0.0003)。这项研究的结果表明，在异基因骨髓移植中，人类白细胞抗原A和B抗原的差异可能比人类白细胞抗原DR等位基因的差异更难耐受。需要进一步的研究来证实我们的结果。(C)美国组织相容性和免疫遗传学会，2001年。爱思唯尔科学公司出版。
The degree of histoincompatibility that can be tolerated, and the relative importance of matching at individual HLA class I and class II locus in bone marrow transplantation (BMT) has not been established. We hypothesized that matching for HLA-DR map nor be more important than matching for HLA-A or HLA-B in selection of a donor for successful BMT. We retrospectively analyzed the outcomes of 248 consecutive pediatric patients who received allogeneic BMT from related donors (RD, n = 119) or unrelated donors (URD, n = 129). HLA-A and HLA-B were serologically marched, and HLA-DRB1 were identical by DNA typing in 69% of donor-recipient pairs. Most patients (89%) had hematologic malignancies; the rest had aplastic anemia or a congenital disorder. One HLA-A antigen mismatch was associated with a decrease in survival (p = 0.003) and a delay in granulocyte engraftment (P = 0.02) in recipients of RD marrow; as well as a decrease in survival (p = 0.02) and the development of severe acute graft-versus-host disease (GVHD) (p = 0.03) in recipients of URD marrow. One HLA-B antigen mismatch was associated with a decrease in the survival (P = 0.05) and the development of severe GVHD (p = 0.0007) in recipients of RD marrow. One HLA-DRB1 allele mismatch was associated only with a decrease in the survival (p = 0.0003) of recipients of RD marrow. Results of this study suggest that disparity in HLA-A and HLA-B antigens may nor be better tolerated than disparity in HLA-DR allele in allogeneic BMT. Further studies are warranted to confirm our results. (C) American Society for Histocompatibility and Immunogenetics, 2001. Published by Elsevier Science Inc.