Chung Hee-Jung, Lee Je-Hwan, Kwon Seog-Woon
Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
J Clin Lab Anal. 2008;22(6):383-90. doi: 10.1002/jcla.20269.
Changes in isoagglutinin titers may have implications in the occurrence of hematological complications such as pure red cell aplasia or immune-mediated hemolysis. Furthermore, isoagglutinin titers could reflect immunohematological reconstitution after transplantation. The objective of this study was to examine the relationship between donor-derived isoagglutinins (DDIs) and graft-versus-host disease (GVHD). In total, 114 patients who underwent ABO-incompatible allogeneic hematopoietic stem cell transplantation (HSCT) were analyzed. Among these patients, 27.7% demonstrated increased donor-derived isoagglutinins (IDDIs) against red blood cells (RBCs) of the recipient, and 32.8% of the patients showed DDIs that were not against RBCs of the recipient. Patients with acute GVHD and DDIs against RBCs of the recipient tended to have higher incidences of IDDIs that occurred before posttransplant day 60 compared with patients without acute GVHD (17.3 vs. 3.9%, P=0.058). In patients with acute GVHD, IDDIs occurred significantly earlier (mean, day 32 vs. 181, P=0.046), the period of elevation was shorter (mean, day 36 vs. 134, P=0.033), and the donors were younger (mean, 28 vs. 36 years, P=0.01) than those without GVHD. Moreover, significant correlations were found between IDDIs and acute GVHD. Taken together, these data underscore a possible role for humoral immunity in GVHD after HSCT.
同种凝集素滴度的变化可能与纯红细胞再生障碍或免疫介导的溶血等血液学并发症的发生有关。此外，同种凝集素滴度可以反映移植后的免疫血液学重建情况。本研究的目的是探讨供体来源的同种凝集素（DDIs）与移植物抗宿主病（GVHD）之间的关系。总共分析了114例接受ABO血型不相合异基因造血干细胞移植（HSCT）的患者。在这些患者中，27.7%表现出针对受者红细胞（RBCs）的供体来源同种凝集素增加（IDDIs），32.8%的患者显示的DDIs不针对受者的RBCs。与没有急性GVHD的患者相比，发生急性GVHD且有针对受者RBCs的DDIs的患者在移植后60天之前出现IDDIs的发生率更高（17.3%对3.9%，P = 0.058）。在患有急性GVHD的患者中，IDDIs出现得明显更早（平均32天对181天，P = 0.046），升高期更短（平均36天对134天，P = 0.033），并且供体比没有GVHD的患者更年轻（平均28岁对36岁，P = 0.01）。此外，发现IDDIs与急性GVHD之间存在显著相关性。综上所述，这些数据强调了体液免疫在HSCT后GVHD中可能发挥的作用。
