[无关供者造血干细胞移植术后患者巨细胞病毒再激活与杀伤细胞免疫球蛋白样受体单倍型/HLA-Cw基因型的关系。]

[Relationship between CMV reactivation and KIR haplotype/HLA-Cw genotype in patients after unrelated-donor hematopoietic stem cell transplantation.].

作者信息

Wu Xiao-Jin, He Jun, Wu De-Pei, Sun Ai-Ning, Bao Xiao-Jing, Qiu Qiao-Cheng, Yuan Xiao-Ni, Li Wei-Yang, Chang Hui-Rong, Han Yue, Ma Xiao, Zhu Zi-Ling, Xu Yang, Feng Yu-Feng, Dai Li-Jun

机构信息

The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou 215006, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2009 Nov;30(11):741-4.

PMID:20137308

Abstract

OBJECTIVE

To explore the relationship between CMV reactivation and KIR haplotype or HLA-Cw genotype in patients after unrelated-donor hematopoietic stem cell transplantation (HSCT).

METHODS

From January 2003 to December 2008 the HLA-Cw/KIR genotype of 48 patient-donor pairs were determined by polymerase chain reaction with sequence specific primers (PCR-SSP) and sequence specific nucleotide (PCR-SSOP). Posttransplant CMV reactivation was performed by immune histochemically assay.

RESULTS

Of 48 patients, 15 were transplanted from unrelated donors with an antigen mismatch for HLA Cw and 33 patient-donor pairs were matched for HLA-Cw. The CMV reaction rate was 66.7% for HLA-Cw mismatch group and 48.5% for HLA-Cw match group (chi(2) = 1.39, P = 0.2375). Thirty-seven donor-patients pairs belonged to group C1 and 11 to group C2, and CMV reaction rate was 64.9% in group C1 and 18.2% in group C2 (chi(2) = 18.13, P < 0.0001). Twenty-six patients received graft from KIR haplotype A (group A donor) and 22 from KIR haplotype B donors (group B donor) and CMV reaction rate was 57.7% in group A donor and 50.0% in group B donor (chi(2) = 0.28, P = 0.5941). The number of donor activating KIRs (aKIRs) was less than that of recipient aKIRs in 34 patient-donor pairs in which the CMV reaction rate was 70.6%, and the number of donor aKIRs was more than that of recipient aKIRs in 14 patient-donor pairs in which the CMV reactivation was 14.3%. There was a significan difference between the two group (chi(2) = 12.44, P = 0.0004).

CONCLUSION

KIR and HLA-Cw genotypes influence the rate of CMV reactivation following non-T cell deleted unrelated donor hematopoietic cell transplantation.

摘要

目的

探讨非亲缘供者造血干细胞移植（HSCT）后患者巨细胞病毒（CMV）再激活与杀伤细胞免疫球蛋白样受体（KIR）单倍型或人类白细胞抗原Cw（HLA-Cw）基因型之间的关系。

方法

2003年1月至2008年12月，采用序列特异性引物聚合酶链反应（PCR-SSP）和序列特异性核苷酸（PCR-SSOP）方法，对48例患者-供者对的HLA-Cw/KIR基因型进行检测。移植后CMV再激活情况采用免疫组织化学方法检测。

结果

48例患者中，15例接受了HLA Cw抗原不匹配的非亲缘供者移植，33例患者-供者对HLA-Cw匹配。HLA-Cw不匹配组CMV反应率为66.7%，HLA-Cw匹配组为48.5%（χ² = 1.39，P = 0.2375）。37例供者-患者对属于C1组，11例属于C2组，C1组CMV反应率为64.9%，C2组为18.2%（χ² = 18.13，P < 0.0001）。26例患者接受了KIR单倍型A供者的移植物（A组供者），22例接受了KIR单倍型B供者的移植物（B组供者），A组供者CMV反应率为57.7%，B组供者为50.0%（χ² = 0.28，P = 0.5941）。在34例患者-供者对中，供者激活型KIR（aKIR）数量少于受者，其CMV反应率为70.6%；在14例患者-供者对中，供者aKIR数量多于受者，其CMV再激活率为14.3%。两组间差异有统计学意义（χ² = 12.44，P = 0.0004）。