Petersdorf E, Anasetti C, Martin P J, Woolfrey A, Smith A, Mickelson E, Malkki M, Lin M T, Hansen J A
University of Washington, School of Medicine, 1959 NE Pacific Street, Seattle, Washington 98105, USA.
Curr Opin Immunol. 2001 Oct;13(5):582-9. doi: 10.1016/s0952-7915(00)00263-6.
Unrelated-donor hematopoietic cell transplantation is a proven curative modality for hematologic malignancies. The success of unrelated-donor transplantation has been achieved through a better understanding of the immunobiology of the HLA system and through more precise and comprehensive matching of donors and recipients. The extensive polymorphism of HLA genes confers important biological implications affecting engraftment, graft-versus-host disease and overall survival. Although more-complete HLA identity of the donor and recipient is associated with optimal transplant outcome, new information suggests that not every HLA disparity is functionally relevant. Future advances in unrelated-donor transplantation must include the identification of tolerable HLA mismatches, so that more patients may benefit from this therapeutic modality. Furthermore, the role of cytokine-gene polymorphisms and minor histocompatibility genes in transplant outcome requires investigation. Delineation of the function of these markers as transplantation determinants may provide alternative means for optimizing the results of hematopoietic cell transplantation.
非血缘供者造血细胞移植是治疗血液系统恶性肿瘤的一种已被证实的治愈性方法。通过对HLA系统免疫生物学的更好理解以及供者与受者更精确和全面的配型，非血缘供者移植取得了成功。HLA基因的广泛多态性具有重要的生物学意义，影响着植入、移植物抗宿主病和总体生存。尽管供者与受者更完全的HLA匹配与最佳移植结果相关，但新信息表明并非每一个HLA差异在功能上都相关。非血缘供者移植未来的进展必须包括确定可耐受的HLA错配，以便更多患者能从这种治疗方法中获益。此外，细胞因子基因多态性和次要组织相容性基因在移植结果中的作用需要研究。将这些标志物的功能描绘为移植决定因素可能为优化造血细胞移植结果提供替代方法。
