Kekik C, Besisik S K, Seyhun Y, Oguz F S, Sargin D, Carin M N
Department of Medical Biology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
Transplant Proc. 2009 Nov;41(9):3859-62. doi: 10.1016/j.transproceed.2009.04.017.
After allogeneic hematopoietic stem cell transplantation, risk factors for cytomegalovirus (CMV) reactivation include pretransplantation donor and recipient CMV serologic status and posttransplantation development of acute graft-vs-host disease (aGvHD). Human leukocyte antigen (HLA) allele type is an additional factor in CMV infection. The present study included 108 patients who received an allogeneic stem cell graft from an HLA-identical sibling between 1993 and 2004. All recipients and donors were typed for HLA-A, HLA-B, and HLA-DR alleles using serologic or molecular methods. All recipients received grafts because of a hematologic disease from HLA full-matched donors. In pretransplantation seropositive patients with aGvHD, no significant difference was observed in patients who developed CMV infection compared with those without CMV infection. Seropositive patients without aGvHD but with posttransplantation CMV infection demonstrated a higher incidence of HLA-A30, HLA-B40, and HLA-DRB1*15 compared with those without CMV infection. In conclusion, it seems that certain HLA alleles may have either a protective or predisposing role in CMV reactivation, which might be helpful in estimating the risk of aGvHD and designing individualized therapy.
异基因造血干细胞移植后,巨细胞病毒(CMV)再激活的危险因素包括移植前供体和受体的CMV血清学状态以及移植后急性移植物抗宿主病(aGvHD)的发生情况。人类白细胞抗原(HLA)等位基因类型是CMV感染的另一个因素。本研究纳入了1993年至2004年间从 HLA 相同的同胞接受异基因干细胞移植的108例患者。所有受者和供者均采用血清学或分子方法对 HLA-A、HLA-B 和 HLA-DR 等位基因进行分型。所有受者均因血液系统疾病接受来自 HLA 完全匹配供者的移植物。在移植前血清学阳性且发生 aGvHD 的患者中,发生 CMV 感染的患者与未发生 CMV 感染的患者之间未观察到显著差异。未发生 aGvHD 但移植后发生 CMV 感染的血清学阳性患者与未发生 CMV 感染的患者相比,HLA-A30、HLA-B40 和 HLA-DRB1*15 的发生率更高。总之,某些 HLA 等位基因似乎在 CMV 再激活中可能具有保护作用或易患作用,这可能有助于评估 aGvHD 的风险并设计个体化治疗方案。