IgM anti-recipient ABO antibodies predict acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation.
IgM anti-recipient ABO antibodies predict acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation.
复制标题
IgM 抗受体 ABO 抗体可预测同种异体造血干细胞移植后的急性移植物抗宿主病。
DOI：
10.1007/s12185-013-1360-6
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Nakao S.
中科院分区：
文献类型：
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作者：
Zaimoku Y;Takami A;Sato H;Utsumi M;Nakao S.
乘客淋巴细胞综合征（PLS）表现为供体b淋巴细胞伴随少量或双向ABO不相容异基因造血干细胞移植（HSCT）而产生的抗受体ABO抗体引起的短暂性免疫溶血。我们监测了18例连续的恶性血液病移植患者的IgM和IgG型抗受体ABO抗体。其中5名患者（28%）在造血干细胞移植后中位19天后由于PLS发生了短暂的免疫性溶血。这种反应与造血干细胞移植后中位时间分别为16天和22天后检测到IgM和IgG抗受体ABO抗体有关。所有5例患者随后均发展为II-IV级急性移植物抗宿主病（GVHD），其中3例患者在移植后1年内死于移植相关死亡率（TRM），而13例无PLS患者中，3例（23%）发展为II-IV级急性GVHD (p< 0.01)， 1年TRM为8% （p= 0.03）。因此，PLS患者的1年总生存率明显低于无PLS患者（20% vs. 75%,p= 0.03）。这些发现表明，IgM抗受体ABO抗体可能是轻度或双向ABO不相容HSCT后急性GVHD和不良生存率的早期预测因子。
Passenger lymphocyte syndrome (PLS) presents as transient immune hemolysis due to anti-recipient ABO antibodies produced by donor B-lymphocytes accompanying minor or bidirectional ABO incompatible allogeneic hematopoietic stem cell transplantation (HSCT). We monitored both IgM and IgG type anti-recipient ABO antibodies in 18 consecutive HSCT recipients with hematological malignancies. Five of these patients (28 %) developed transient immune hemolysis due to PLS after a median of 19 days post-HSCT. This response was associated with the detection of IgM and IgG anti-recipient ABO antibodies after a median of 16 and 22 days post-HSCT, respectively. All five patients subsequently developed acute graft-versus-host disease (GVHD) grades II–IV, and three died due to transplant-related mortality (TRM) within 1 year after HSCT, while in contrast, of the 13 patients without PLS, three (23 %) developed grades II–IV acute GVHD (p< 0.01) and the 1-year TRM was 8 % (p= 0.03). Thus, patients with PLS had a significantly lower 1-year overall survival than those without PLS (20 vs. 75 %,p= 0.03). These findings suggest that the IgM anti-recipient ABO antibody may be an early predictor of acute GVHD and poor survival after minor or bidirectional ABO incompatible HSCT.