Leukemia Research Center, Saiseikai Maebashi Hospital, Kamishinden-machi, 564-1 Maebashi, Gunma, Japan.
Int J Hematol. 2013 Apr;97(4):535-9. doi: 10.1007/s12185-013-1304-1. Epub 2013 Mar 3.
The presence of pre-transplant anti-HLA antibodies in recipients of cord blood transplantation (CBT) is associated with failed engraftment. However, only a small number of studies have reported that recipient-derived anti-HLA antibodies persist after CBT and have potential impact on the outcome. Of 61 patients who underwent HLA-mismatched CBT at Saiseikai Maebashi Hospital, three patients were identified as having anti-HLA antibodies not corresponding to HLA antigens in the transplanted CB. All patients achieved successful engraftment. However, the three patients with the pre-transplant anti-HLA antibodies not corresponding to HLA antigens in the transplanted CB continued to produce these antibodies even after engraftment; the persistence of these antibodies served as a sensitive minimal residual disease (MRD) marker. In contrast, donor HLA-specific and newly produced third party antibodies were not detectable even after relapse. The persistence of anti-HLA antibodies even after engraftment may be a potential marker for MRD, but is not a significant factor in secondary humoral engraftment failure.
在接受脐带血移植（CBT）的患者中，移植前存在抗 HLA 抗体与植入失败有关。然而，仅有少数研究报道了受体来源的抗 HLA 抗体在 CBT 后持续存在，并可能对结果产生影响。在兵库县明和会前桥医院接受 HLA 错配 CBT 的 61 例患者中，有 3 例患者被确定为具有与移植 CB 中 HLA 抗原不对应的抗 HLA 抗体。所有患者均成功植入。然而，这 3 例具有与移植 CB 中 HLA 抗原不对应的移植前抗 HLA 抗体的患者，即使在植入后仍继续产生这些抗体；这些抗体的持续存在是敏感的微小残留病（MRD）标志物。相比之下，即使在复发后，也无法检测到供体 HLA 特异性和新产生的第三方抗体。即使在植入后，抗 HLA 抗体的持续存在也可能是 MRD 的潜在标志物，但不是二次体液植入失败的重要因素。
