Limits of HLA mismatching in unrelated hematopoietic cell transplantation
Limits of HLA mismatching in unrelated hematopoietic cell transplantation
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DOI：
10.1182/blood-2004-04-1674
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发表时间：
2004-11-01
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;Anasetti, C;Hansen, JA
供受者之间的HLA配型可提高非亲缘造血细胞移植（HCT）的成功率。匹配的捐赠者仅适用于少数患者。需要进一步的信息来评估HLA错配的限度。我们研究了948例接受T-完全无关HCT治疗骨髓疾病的患者的死亡率与HLA-A、-B、-C、-DRB 1和-DQB 1不匹配的关系。与没有HLA错配的患者相比，单个HLA等位基因或抗原错配与慢性粒细胞白血病（CML）患者诊断后2年内死亡率增加相关，但与更晚期恶性肿瘤患者无关。特别是，与匹配相比，单一HLA-C错配导致死亡风险增加。与不涉及HLA-DQB 1的多个错配相比，涉及HLA-DQB 1的多个错配的死亡率增加。当完全匹配的供体不适用于患有不允许长时间搜索的疾病的患者时，具有单个HLA等位基因或抗原错配的供体可用于HCT。在可能的情况下，早期CML患者应避免HLA-C错配，多错配患者应避免HLA-DQB 1错配。(C)2004年，美国血液学会。
HLA matching between the donor and recipient improves the success of unrelated hematopoietic cell transplantation (HCT). Matched donors are available for only a minority of patients. Further information is needed to evaluate the limits of HLA mismatching. We examined the association of mortality with HLA-A, -B, -C, -DRB1, and -DQB1 mismatching in 948 patients who received a T-replete unrelated HCT for treatment of a marrow disorder. A single HLA allele or antigen mismatch was associated with increased mortality among patients with chronic myeloid leukemia (CML) within 2 years after diagnosis compared to patients with no HLA mismatch, but not among those with more advanced malignancy. In particular, a single HLA-C mismatch conferred increased risk of mortality compared to matches. There was a suggestion for increased mortality with multiple mismatches involving HLA-DQB1 compared to multiple mismatches not involving HLA-DQB1. Donors with a single HLA allele or antigen mismatch may be used for HCT when a fully matched donor is not available for patients with diseases that do not permit time for a lengthy search. Whenever possible, HLA-C mismatches should be avoided for patients with early stage CML, and HLA-DQB1 mismatches should be avoided for patients with multiple mismatches. (C) 2004 by The American Society of Hematology.