地中海贫血移植患者中受者微小组织相容性抗原-HA1不匹配与急性移植物抗宿主病

Recipient mHag-HA1 disparity and aGVHD in thalassemic-transplanted patients.

作者信息

Nesci S, Buffi O, Iliescu A, Andreani M, Lucarelli G

机构信息

Laboratorio de Ricerca Onco-Ematologico, Dipartimento di Onco Ematologia, Pesaro, Italy.

出版信息

Bone Marrow Transplant. 2003 Apr;31(7):575-8. doi: 10.1038/sj.bmt.1703880.

DOI:10.1038/sj.bmt.1703880

PMID:12692624

Abstract

In order to determine the influence of HA-1 minor histocompatibility antigen mismatch on BMT outcome, we analyzed a pool of 94 thalassemic transplanted patients all selected for the presence of HLA-A(*)0201 allele. The HA-1 typing was performed using SSP analysis. All the patients received bone marrow from HLA-identical MLC nonresponsive siblings. As graft-versus-host-disease (GVHD) prophylaxis, all patients received cyclosporin and short methotrexate. Grades II-IV GVHD occurred in five (33.3%) of the 15 patients with recipient HA-1 disparity compared with 14 (17.7%) of the 79 patients without HA-1 disparity. Despite the higher incidence of acute graft-versus-host-disease (aGVHD) in the group of patients with HA-1 incompatibility, these data were not statistically significant. However, it was interesting to observe that no GVHD developed in any of the 15 cases in which the recipient was HA-1 negative and the donor HA-1 positive.

摘要

为了确定HA-1次要组织相容性抗原错配对骨髓移植结果的影响，我们分析了一组94例地中海贫血移植患者，所有患者均因存在HLA-A(*)0201等位基因而入选。采用序列特异性引物（SSP）分析法进行HA-1分型。所有患者均接受来自HLA相同且混合淋巴细胞培养无反应的同胞的骨髓。作为移植物抗宿主病（GVHD）预防措施，所有患者均接受环孢素和短疗程甲氨蝶呤治疗。15例受体HA-1不相合的患者中有5例（33.3%）发生了II-IV级GVHD，而79例无HA-1不相合的患者中有14例（17.7%）发生了GVHD。尽管HA-1不相容组急性移植物抗宿主病（aGVHD）的发生率较高，但这些数据无统计学意义。然而，有趣的是，在15例受体为HA-1阴性而供体为HA-1阳性的病例中，无一例发生GVHD。