Optimizing outcome after unrelated marrow transplantation by comprehensive matching of HLA class I and II alleles in the donor and recipient
Optimizing outcome after unrelated marrow transplantation by comprehensive matching of HLA class I and II alleles in the donor and recipient
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DOI：
10.1182/blood.v92.10.3515.422k49_3515_3520
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发表时间：
1998-11-15
期刊：
影响因子：
20.3
通讯作者：
Hansen, JA
中科院分区：
文献类型：
--
作者：
Petersdorf, EW;Gooley, TA;Hansen, JA
在非亲属骨髓移植中，供体和受体的II类HLA-DRB1和DQB1等位基因匹配的益处已得到充分证明。对于I类HLA-A， B和C等位基因匹配的临床相关性知之甚少。我们使用dna扩增方法鉴定了300名患者及其供体的HLA-A、B和C等位基因。移植失败的发生率与供体中多次I级错配相关。III-IV级急性移植物抗宿主病的风险在受体II级错配时最高。单个I类或II类等位基因的错配对存活率没有影响，但一个以上I类等位基因的错配以及I类和II类等位基因的同时错配会增加死亡率。我们得出结论，供体和受体HLA I类和II类等位基因的匹配可以改善非亲属骨髓移植后的预后。(C) 1998年由美国血液病学会出版。
In unrelated marrow transplantation, the benefit of matching class II HLA-DRB1 and DQB1 alleles of the donor and recipient is well documented. Little is known about the clinical relevance of matching for class I HLA-A, B, and C alleles. We used DNA-amplification methods to identify the HLA-A, B, and C alleles of 300 patients and their donors. The incidence of graft failure was correlated with multiple class I mismatching in the donor. The risk of grades III-IV acute graft-versus-host disease was highest with class II mismatching in the recipient. Mismatching for a single class I or class II allele had no effect on survival, but mortality was increased by mismatching for more than one class I allele and by simultaneous mismatching for class I and class II alleles. We conclude that matching HLA class I and class II alleles of the donor and recipient can improve outcome after unrelated marrow transplantation. (C) 1998 by The American Society of Hematology.