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维生素 D 受体基因多态性对 HLA 匹配同胞造血干细胞移植临床结局的影响。

Impact of vitamin D receptor gene polymorphisms on clinical outcomes of HLA-matched sibling hematopoietic stem cell transplantation.

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Clin Transplant. 2012 May-Jun;26(3):476-83. doi: 10.1111/j.1399-0012.2011.01523.x. Epub 2011 Oct 31.

Abstract

We hypothesized that polymorphisms of the vitamin D receptor (VDR) gene might affect clinical outcomes of allogeneic hematopoietic stem cell transplantation (HSCT). Three VDR gene polymorphisms (BsmI G>A, ApaI G>T, and TaqI T>C) were genotyped in 147 patients who underwent HLA-matched sibling allogeneic HSCT. Frequencies of infection, graft-vs.-host disease (GVHD), overall survival (OS), and disease-free survival (DFS) were compared according to genotypes and haplotypes. Infection and acute GVHD had trends to be less frequent in patients with ApaI TT genotype than non-TT genotypes (p = 0.061 and p = 0.059, respectively). For TaqI genotypes, there were no statistical differences in frequency of infection and acute GVHD (p = 0.84 and p = 0.30, respectively), but TC genotype was associated with longer OS and DFS than TT genotype (p = 0.022 and p = 0.038, respectively). In the ApaI-TaqI haplotype analysis, patients with TC haplotype had significantly longer OS and DFS than those without TC haplotype (p = 0.022 and p = 0.038, respectively). In multivariable analysis, TaqI genotype and ApaI-TaqI haplotype of recipients were independent prognostic factors for both OS and DFS. This study suggests that the genotype and haplotype of VDR in recipient might be associated with clinical outcome of sibling HLA-matched HSCT.

摘要

我们假设维生素 D 受体 (VDR) 基因的多态性可能会影响异基因造血干细胞移植 (HSCT) 的临床结果。在 147 例接受 HLA 匹配的同胞异基因 HSCT 的患者中,对 VDR 基因的 3 个多态性(BsmI G>A、ApaI G>T 和 TaqI T>C)进行了基因分型。根据基因型和单倍型比较了感染、移植物抗宿主病 (GVHD)、总生存率 (OS) 和无病生存率 (DFS) 的频率。与非 TT 基因型相比,ApaI TT 基因型患者的感染和急性 GVHD 发生率呈下降趋势(p=0.061 和 p=0.059)。对于 TaqI 基因型,感染和急性 GVHD 的频率无统计学差异(p=0.84 和 p=0.30),但 TC 基因型与 TT 基因型相比,OS 和 DFS 更长(p=0.022 和 p=0.038)。在 ApaI-TaqI 单倍型分析中,携带 TC 单倍型的患者 OS 和 DFS 明显长于不携带 TC 单倍型的患者(p=0.022 和 p=0.038)。多变量分析显示,受者的 TaqI 基因型和 ApaI-TaqI 单倍型是 OS 和 DFS 的独立预后因素。本研究表明,受者 VDR 的基因型和单倍型可能与同胞 HLA 匹配 HSCT 的临床结果相关。

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