Wang Hua, He Yi, Wang He-Hua, Wang Mei, Zhai Wen-Jing, Zhou Zheng, Zhang Rong-Li, Zhai Wei-Hua, Feng Si-Zhou, Han Ming-Zhe
Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008 Feb;16(1):111-5.
The aim of this study was to evaluate the impact of donor killer cell immunoglobulin-like receptor (KIR) and recipient HLA genotypes on outcome following haploidentical hematopoietic stem cell transplantation (HSCT). 26 patients with hematologic diseases received non T-cell-depleted (TCD) in vitro transplant from haploidentical donor. Donor/recipient HLA and donor KIR genotypes were determined by polymerase chain reaction-sequence-specific primer (PCR-SSP). Donor/recipient KIR/HLA subgroup was assessed by donors KIR and recipients HLA-Bw4, Cw1 group and Cw2 group alleles. Hematopoietic reconstitution, incidence of graft versus host disease (GVHD), disease-free survival (DFS), infection and transplant-related mortality (TRM) were analyzed between every two groups. The influence of donor activating KIR on outcome following haploidentical HSCT also has been studied. The results showed that hematopoietic reconstitution, incidence of GVHD, DFS, infection and TRM were not significantly different between every two groups (p>0.05). There were 4 cases of severe GVHD in C2 mismatched group. The donor activating KIR2DS5 positive group had higher 2-year DFS compared with the negative group [(85.7+/-13.2)% vs (31.2+/-12.8)%, p<0.05]. It is concluded that KIR/HLA genotypes between donor and recipient influence the outcome following haploidentical HSCT. Donor activating KIR2DS5 may improve DFS in non TCD haploidentical HSCT.
本研究旨在评估供体杀伤细胞免疫球蛋白样受体（KIR）和受体人类白细胞抗原（HLA）基因型对单倍体相合造血干细胞移植（HSCT）后结局的影响。26例血液病患者接受了来自单倍体相合供体的非T细胞去除（TCD）体外移植。通过聚合酶链反应-序列特异性引物（PCR-SSP）确定供体/受体HLA和供体KIR基因型。通过供体KIR和受体HLA-Bw4、Cw1组和Cw2组等位基因评估供体/受体KIR/HLA亚组。分析每两组之间的造血重建、移植物抗宿主病（GVHD）发生率、无病生存率（DFS）、感染及移植相关死亡率（TRM）。还研究了供体激活型KIR对单倍体相合HSCT后结局的影响。结果显示，每两组之间的造血重建、GVHD发生率、DFS、感染及TRM差异均无统计学意义（p>0.05）。C2错配组有4例重度GVHD。供体激活型KIR2DS5阳性组的2年DFS高于阴性组[（85.7±13.2）%对（31.2±12.8）%，p<0.05]。结论是供体与受体之间的KIR/HLA基因型影响单倍体相合HSCT后的结局。供体激活型KIR2DS5可能改善非TCD单倍体相合HSCT的DFS。
