Ma Hong-jing, Yin Xiao-lin, Guo Kun-yuan, Xiao Lu-lu, Ye Xin
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
Zhonghua Xue Ye Xue Za Zhi. 2006 Feb;27(2):91-4.
To explore the relationship between the genetic background of donor KIR/recipient HLA and the outcomes in HLA-identical sibling HSCT.
HLA genotype was determined by polymerase chain reaction-sequence-specific oligonucleotide probes (PCR-SSOP) and/or PCR-sequence-specific primer (PCR-SSP). Donor KIR genotype was determined by PCR-SSP. A retrospective study was carried out to analyze the outcomes of 59 patients with various hematologic malignancies received non T-cell-depleted transplant from HLA-identical sibling donors.
Incidence of grade II-IV acute graft-versus-host disease (aGVHD) was significantly lower in patients of KIR/HLA matched group than in KIR/HLA mismatched group (32% vs 78%, P = 0.026). The incidence of grade II-IV aGVHD (24% vs 61%, P = 0.018) and fungus infection (14% vs 44%, P = 0.028) were significantly lower in Bw4 matched group than in Bw4 mismatched group. In myeloid diseases, Bw4 matched patients had much lower incidence of fungus infection (12% vs 80%, P = 0.002) compared with Bw4 mismatched patients, and C2 matched patients had higher overall survival (OS) compared with C2 mismatched patients (P = 0.01).
Donor KIR/recipient HLA genetic background is correlated with the outcomes of HLA-identical sibling HSCT in incidences of grade II-IV aGVHD, fungus infection and OS. KIR/HLA matched patients may have lower incidence of aGVHD. Bw4 matched patients may have lower incidences of aGVHD and fungus infection. C2 matched patients may have longer OS.
探讨供者杀伤细胞免疫球蛋白样受体(KIR)/受者人类白细胞抗原(HLA)的遗传背景与HLA全相合同胞造血干细胞移植(HSCT)结局之间的关系。
采用聚合酶链反应-序列特异性寡核苷酸探针(PCR-SSOP)和/或聚合酶链反应-序列特异性引物(PCR-SSP)检测HLA基因型。采用PCR-SSP检测供者KIR基因型。对59例接受HLA全相合同胞供者非T细胞去除移植的各种血液系统恶性肿瘤患者的结局进行回顾性研究。
KIR/HLA匹配组患者Ⅱ-Ⅳ度急性移植物抗宿主病(aGVHD)的发生率显著低于KIR/HLA不匹配组(32%对78%,P = 0.026)。Bw4匹配组Ⅱ-Ⅳ度aGVHD的发生率(24%对61%,P = 0.018)和真菌感染率(14%对44%,P = 0.028)显著低于Bw4不匹配组。在髓系疾病中,与Bw4不匹配患者相比,Bw4匹配患者的真菌感染率低得多(12%对80%,P = 0.002),C2匹配患者的总生存期(OS)高于C2不匹配患者(P = 0.01)。
供者KIR/受者HLA遗传背景与HLA全相合同胞HSCT在Ⅱ-Ⅳ度aGVHD发生率、真菌感染率和OS方面的结局相关。KIR/HLA匹配的患者aGVHD发生率可能较低。Bw4匹配的患者aGVHD和真菌感染发生率可能较低。C2匹配的患者OS可能更长。