Kim Hee Je, Park Soo Jeong, Im Hyun Woo, Kim Dong Wook, Min Woo Sung, Kim Hack Ki, Kim Won Il, Kim Kwang Sung, Kim Chun Choo
Catholic Hemopoietic Stem Cell Transplantation Center, The Catholic University of Korea, Seoul.
Int J Hematol. 2002 Oct;76(3):267-71. doi: 10.1007/BF02982797.
We analyzed the association of HLA antigens with incidence of organ-specific graft-versus-host disease (GVHD) after allogeneic hemopoietic stem cell transplantation (allo-HSCT) from an HLA-matched sibling donor. We retrospectively reviewed the clinical records of allo-HSCT recipients and found 389 patients who had received matched-sibling HSCT. HLA types, GVHD grades, and the development of acute or chronic GVHD, factors that reflect a certain immunological impact associated with involved organs, were investigated. The overall incidence of acute and chronic GVHD was 24.8% (96 cases) and 21.2% (82 cases), respectively. The incidence of acute GVHD with grades II through IV was higher among patients who had HLA-B61 (P = .0153) and HLA-Cw3 (P = .0208). The donor sex (P = .0040) and the conditioning regimen (P = .0010) were also associated with severe acute GVHD. The extensive-type chronic GVHD incidence was higher in patients who had HLA-B54 (P = .0159). The donor sex (P = .0406) and the pretransplantation diagnosis (P = .0184) were other factors associated with the development of extensive-type chronic GVHD. Furthermore, HLA-B35 (P = .0226) and HLA-B54 (P = .0091) were associated with a higher incidence of severe acute skin GVHD and chronic skin and oral GVHD (in descending order of incidence rates). HLA-B7,27 was associated with chronic liver GVHD (P = .0476) in addition to other parameters including patient (P = .0246) and donor sex (P = .0019). This study shows that these remarkable HLA antigens may be potent transplantation immune regulators, but there is a need for further evaluation using larger study samples.
我们分析了 HLA 抗原与来自 HLA 匹配同胞供体的异基因造血干细胞移植(allo-HSCT)后器官特异性移植物抗宿主病(GVHD)发生率之间的关联。我们回顾性地查阅了 allo-HSCT 受者的临床记录,发现 389 例接受了同胞匹配 HSCT 的患者。对 HLA 类型、GVHD 分级以及急性或慢性 GVHD 的发生情况进行了调查,这些因素反映了与受累器官相关的特定免疫影响。急性和慢性 GVHD 的总体发生率分别为 24.8%(96 例)和 21.2%(82 例)。HLA-B61(P = 0.0153)和 HLA-Cw3(P = 0.0208)的患者中,II 至 IV 级急性 GVHD 的发生率较高。供体性别(P = 0.0040)和预处理方案(P = 0.0010)也与严重急性 GVHD 相关。HLA-B54 的患者中广泛性慢性 GVHD 的发生率较高(P = 0.0159)。供体性别(P = 0.0406)和移植前诊断(P = 0.0184)是与广泛性慢性 GVHD 发生相关的其他因素。此外,HLA-B35(P = 0.0226)和 HLA-B54(P = 0.0091)与严重急性皮肤 GVHD 以及慢性皮肤和口腔 GVHD 的较高发生率相关(按发生率降序排列)。除了包括患者(P = 0.0246)和供体性别(P = 0.0019)等其他参数外,HLA-B7,27 与慢性肝脏 GVHD 相关(P = 0.0476)。本研究表明,这些显著的 HLA 抗原可能是有效的移植免疫调节因子,但需要使用更大的研究样本进行进一步评估。