Impact of HLA class I high-resolution mismatches on chronic graft-versus-host disease and survival of patients given hematopoietic stem cell grafts from unrelated donors
Impact of HLA class I high-resolution mismatches on chronic graft-versus-host disease and survival of patients given hematopoietic stem cell grafts from unrelated donors
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DOI：
10.1038/sj.bmt.1704741
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发表时间：
2005-01-01
影响因子：
4.8
通讯作者：
Fischer, GF
中科院分区：
文献类型：
--
作者：
Greinix, HT;Faé, I;Fischer, GF
无亲缘关系供者（URD）与患者HLA II类等位基因匹配可改善造血干细胞移植（HSCT）的结局，这已成为共识。然而，HLA I类等位基因错配对移植结果的重要性仍在讨论中，关于慢性移植物抗宿主病（GVHD）等长期效应的报道很少。因此，我们在144名HLA-DRB 1、DRB 3/4/5和DQB 1等位基因匹配的URD患者中研究了人类白细胞抗原（HLA）I类等位基因错配与结局的相关性。慢性GVHD的风险显着增加的患者与I类不匹配的捐助者，无论是检测低或高分辨率分型的不匹配。多因素分析显示，单个HLA I类等位基因错配显著增加慢性GVHD的风险。总生存率显着降低患者/供体对超过一个等位基因I类错配。因此，选择无关供者进行移植应基于高分辨率HLA I类分型。
There is consensus that matching of unrelated donors (URD) and patients for HLA class II alleles improves the outcome of hematopoietic stem cell transplantation (HSCT). However, the significance of HLA class I allelic mismatches for transplant outcome is under discussion and reports on long-term effects like chronic graft-versus-host disease (GVHD) a re rare. Thus, we investigated the association of human leukocyte antigen (HLA) class I allele mismatches and outcome in 144 patients given HSCT from URD who were matched for HLA-DRB1, DRB3/4/5, and DQB1 alleles. The risk of chronic GVHD was significantly increased in patients with class I mismatched donors, the mismatch either detected by low- or high-resolution typing. A single HLA class I allele mismatch significantly increased the risk of chronic GVHD in multivariate analysis. Overall survival was significantly reduced in patient/donor pairs with more than one-allele class I mismatch. Thus, selection of unrelated donors for transplantation should be based on high-resolution HLA class I typing.