Clinical implications of HLA locus mismatching in unrelated donor hematopoietic cell transplantation: a meta-analysis.
Clinical implications of HLA locus mismatching in unrelated donor hematopoietic cell transplantation: a meta-analysis.
复制标题
非亲缘供者造血细胞移植中 HLA 位点不匹配的临床意义：一项荟萃分析
DOI：
10.18632/oncotarget.15291
复制
发表时间：
2017-04-18
期刊：
影响因子：
--
通讯作者：
Huang H
中科院分区：
文献类型：
--
作者：
Tie R;Zhang T;Yang B;Fu H;Han B;Yu J;Tan Y;Huang H
与HLA等位基因匹配的对照组相比，个体HLA位点不匹配对接受非亲属供体造血细胞移植（HCT）患者临床结果的影响仍然存在争议。我们进行了一项荟萃分析来解决这些问题。检索四个数据库（PubMed, Embase， Web of Science和Cochrane Library）以选择符合条件的研究。所有供体-受体对均进行HLA-A、-B、-C、-DRB1、DQB1和DPB1位点的高分辨率分型。采用随机效应模型提取并汇总多变量校正风险比（hr）。共纳入36项研究，100,072例患者接受HCT。令人惊讶的是，我们发现HLA-DQB1位点错配并没有显著增加多种结局的风险，包括急性和慢性移植物抗宿主病（GVHD）、总死亡率和疾病复发（HR, 1.07; P = 0.153； HR, 1.07; P = 0.142； HR, 1.09; P = 0.230； HR, 1.07; P = 0.142和HR， 1.02; P = 0.806）。不匹配的HLA-DPB1与疾病复发风险降低显著相关（HR, 0.74, P < 0.001），但与移植相关死亡率（TRM）和总死亡率风险增加无关（HR, 1.09, P = 0.591; I2 = 74.2%， HR, 1.03, P = 0.460）。总之，HLA-DQB1基因座错配是一种允许型错配。HLA-DPB1基因座错配对白血病复发有显著保护作用。个体HLA位点错配的精炼效应有助于预测接受非亲属供体HCT患者的预后。
It remains controversial that the impacts of individual HLA locus mismatches on clinical outcomes of patients receiving unrelated-donor hematopoietic cell transplantation (HCT), as compared to HLA allele matched controls. We conducted a meta-analysis to address these issues. Four databases (PubMed, Embase, Web of Science and the Cochrane Library) were searched to select eligible studies. All donor-recipient pairs were high-resolution typing for HLA-A, -B, -C, -DRB1, DQB1 and DPB1 loci. Multivariate-adjusted hazard ratios (HRs) were extracted and pooled using a random-effects model. A total of 36 studies were included, with 100,072 patients receiving HCT. Surprisingly, we found that HLA-DQB1 locus mismatches had no significantly increased risk of multiple outcomes including acute and chronic graft-versus-host disease (GVHD), overall mortality and disease relapse (HR, 1.07; P = .153; HR, 1.07; P = .271; HR, 1.09; P = .230; HR, 1.07; P = .142 and HR, 1.02; P = .806, respectively). Mismatched HLA-DPB1 was significantly associated with a reduced risk of disease relapse (HR, 0.74; P < .001) but not with increased risks of transplant-related mortality (TRM) and overall mortality (HR, 1.09; P = .591; I2 = 74.2% and HR, 1.03; P = .460, respectively). In conclusion, HLA-DQB1 locus mismatches is a permissive mismatching. HLA-DPB1 locus mismatches significantly protect against leukemia relapse. Refining effects of individual HLA locus mismatches contributes to predicting prognosis of patients receiving unrelated donor HCT.
DOI：
10.5045/kjh.2011.46.1.11
发表时间：
2011-03
期刊：
The Korean journal of hematology
影响因子：
--
作者：
Park M;Koh KN;Kim BE;Im HJ;Park KD;Kang HJ;Shin HY;Ahn HS;Yoo KH;Sung KW;Koo HH;Park HJ;Park BK;Seo JJ
通讯作者：
Seo JJ