HLA matching in allogeneic stem cell transplantation
HLA matching in allogeneic stem cell transplantation
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DOI：
10.1097/01.moh.0000143701.88042.d9
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发表时间：
2004-11-01
影响因子：
3.2
通讯作者：
Petersdorf, EW
中科院分区：
文献类型：
--
作者：
Petersdorf, EW
审查目的无关造血细胞移植（HCT）的成功受到供体和患者之间HLA相容性程度的影响。本综述的目的是总结使用清髓预处理方案的无关供体的免疫遗传学和 HCT 领域的新发现。最新发现分子分型方法可以区分由 HLA I 类和 11 基因编码的独特等位基因。供体与受体 HLA 等位基因的不相容性会增加移植后并发症，包括移植物排斥、急性和慢性移植物抗宿主病以及死亡率。这些移植后风险随着 HLA 不匹配数量的增加而增加。使用功能测定可以帮助识别允许的 HLA 错配。非遗传因素，包括移植时的疾病阶段，可能会影响 HLA 不匹配对生存的影响。总结 HLA 等位基因具有功能相关性。不相关的 HCT 可以通过全面、精确的供体-受体等位基因匹配来优化。对于患有高危疾病且缺乏匹配供体的患者，使用具有单一 HLA 不匹配的供体可能允许在疾病进展之前进行早期治疗。
Purpose of review The success of unrelated hematopoietic cell transplantation (HCT) is influenced by the degree of HLA compatibility between the donor and patient. The goal of this review is to summarize new findings in the field of immunogenetics and HCT from unrelated donors using myeloablative conditioning regimens.Recent findings Molecular typing methods can discriminate unique alleles encoded by HLA class I and 11 genes. Incompatibility of donor-recipient HLA alleles increases posttransplant complications including graft rejection, acute and chronic graft-versus-host disease, and mortality. These posttransplant risks increase with increasing numbers of HLA mismatches. The identification of permissible HLA mismatches may be aided by the use of functional assays. Nongenetic factors, including the stage of disease at the time of transplantation, may influence the effect of HLA mismatching on survival.Summary HLA alleles are functionally relevant. Unrelated HCT can be optimized by comprehensive and precise donor-recipient allele matching. For patients with high-risk diseases who lack matched donors, use of donors with a single HLA mismatch may permit early treatment before disease progression.