Gahrton Gösta
Karolinska Institutet, Department of Medicine and Karolinska University Hospital, Huddinge, SE 14186 Stockholm, Sweden.
Best Pract Res Clin Haematol. 2007 Jun;20(2):219-29. doi: 10.1016/j.beha.2006.09.007.
In allogeneic transplantation the donor-recipient sex combination plays a role in outcome. In large retrospective registry studies of several thousands of patients with aplastic anemia, chronic myelocytic leukemia (CML), acute myelocytic leukemia (AML), and multiple myeloma, chronic graft-versus-host disease (cGVHD) was more frequent and transplant-related mortality (TRM) higher in males with a female donor (F-->M) than in other donor-recipient sex combinations. Graft rejection was more frequent in females with a male donor (M-->F) in aplastic anemia, and a graft-versus-tumor effect (GVT) was documented as a reduced relapse rate in F-->M in CML, AML and multiple myeloma. The overall survival was adversely affected in F-->M in aplastic anemia, AML and CML and in M-->F in aplastic anemia. These results support the view that donor T cells specific for male minor histocompatiblity antigens encoded by Y-chromosome genes contribute to GVHD, graft rejection, GVT and survival in sex-mismatched transplants.
在同种异体移植中，供受者的性别组合对移植结果有影响。在针对数千例再生障碍性贫血、慢性粒细胞白血病（CML）、急性粒细胞白血病（AML）和多发性骨髓瘤患者的大型回顾性登记研究中，女性供者（F→M）的男性受者发生慢性移植物抗宿主病（cGVHD）的频率更高，移植相关死亡率（TRM）也高于其他供受者性别组合。在再生障碍性贫血中，男性供者（M→F）的女性受者发生移植物排斥的频率更高，并且在CML、AML和多发性骨髓瘤中，F→M的移植物抗肿瘤效应（GVT）表现为复发率降低。在再生障碍性贫血、AML和CML中，F→M以及在再生障碍性贫血中M→F的总体生存率均受到不利影响。这些结果支持以下观点：由Y染色体基因编码的针对男性次要组织相容性抗原的供者T细胞，在性别不匹配的移植中对GVHD、移植物排斥、GVT和生存产生影响。
