Petersdorf Effie W
Division of Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, D4-100, Seattle, WA 98109-1024, United States.
Curr Opin Immunol. 2008 Oct;20(5):588-93. doi: 10.1016/j.coi.2008.06.014. Epub 2008 Aug 8.
Only 30% of patients in need of a hematopoietic cell transplant will have an HLA identical sibling to serve as the donor. Advances in the field of immunogenetics together with the growth of donor registries and cord blood banks worldwide have provided many of these patients the opportunity for a life saving transplant. Current data demonstrate the importance of matching the unrelated donor for HLA alleles and antigens. When a matched volunteer donor is not available, use of mismatched donors may be considered. New concepts in the selection of mismatched donors include consideration for the locus, the number of mismatches, differences between alleles and antigens, the location and nature of amino acid mismatches that define class I epitopes, and the presence of haplotype mismatching. When cord blood transplantation is an option, both cell dose and HLA matching are important variables. Optimizing the overall outcome of hematopoietic cell transplantation requires an appreciation for the relative importance of HLA factors with respect to other non-genetic factors that also influence transplant outcome.
仅30% 需要进行造血细胞移植的患者有 HLA 匹配的同胞供体。免疫遗传学领域的进展以及全球范围内供体登记处和脐带血库的发展，为许多此类患者提供了挽救生命的移植机会。目前的数据表明了HLA 等位基因和抗原与无关供体匹配的重要性。当没有匹配的志愿供体时，可以考虑使用不匹配的供体。选择不匹配供体的新概念包括考虑基因座、不匹配的数量、等位基因和抗原之间的差异、定义 I 类表位的氨基酸不匹配的位置和性质，以及单倍型不匹配的存在。当脐带血移植是一种选择时，细胞剂量和 HLA 匹配都是重要变量。优化造血细胞移植的总体结果需要认识到 HLA 因素相对于其他也影响移植结果的非遗传因素的相对重要性。
