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HLA 特异性与弥漫性大 B 细胞淋巴瘤的发生和预后有关。

HLA specificities are related to development and prognosis of diffuse large B-cell lymphoma.

机构信息

Department of Hematology, University Hospital of Salamanca, Paseo de San Vicente 58-182, Salamanca, Spain.

出版信息

Blood. 2013 Aug 22;122(8):1448-54. doi: 10.1182/blood-2013-02-483420. Epub 2013 Jul 10.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is an aggressive disease influenced by genetic and environmental factors. The role of the HLA system in tumor antigen presentation could be involved in susceptibility and disease control. We analyzed the phenotypic frequencies of HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 in 250 DLBCLs, comparing them with 1940 healthy individuals. We also evaluated the influence of HLA polymorphisms on survival in those patients treated with curative intention using cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP)-like regimen without (n = 64, 26%) or with (n = 153, 61%) rituximab. DLBCL patients have a higher phenotypic frequency of HLA-DRB101 (29% vs 19.5%, P = .0008, Pc = .0104) and a lower frequency of HLA-C03 (6.4% vs 17.9%, P < .0005, Pc = .007) compared with healthy individuals. Irrespective of the age-adjusted International Prognostic Index, those patients receiving a CHOP-like plus rituximab regimen and carrying the HLA-B44 supertype had worse 5-year progression-free (54% vs 71%, P = .019) and 5-year overall (71% vs 92%, P = .001) survival compared with patients without this supertype. Our data suggest that some HLA polymorphisms influence the development and outcome of DLBCL, allowing the identification of an extremely good-risk prognostic subgroup. However, these results are preliminary and need to be validated in order to exclude a possible population effect.

摘要

弥漫性大 B 细胞淋巴瘤 (DLBCL) 是一种受遗传和环境因素影响的侵袭性疾病。HLA 系统在肿瘤抗原呈递中的作用可能与易感性和疾病控制有关。我们分析了 250 例 DLBCL 患者和 1940 例健康个体的 HLA-A、HLA-B、HLA-C、HLA-DRB1 和 HLA-DQB1 的表型频率。我们还评估了 HLA 多态性对接受环磷酰胺、多柔比星、长春新碱和泼尼松 (CHOP) 样方案无 (n = 64,26%) 或有 (n = 153,61%) 利妥昔单抗治疗的患者生存的影响。与健康个体相比,DLBCL 患者 HLA-DRB101 的表型频率更高 (29%比 19.5%,P =.0008,Pc =.0104),而 HLA-C03 的频率更低 (6.4%比 17.9%,P <.0005,Pc =.007)。无论年龄调整后的国际预后指数如何,接受 CHOP 样加利妥昔单抗方案且携带 HLA-B44 超型的患者,5 年无进展生存 (54%比 71%,P =.019) 和 5 年总生存 (71%比 92%,P =.001) 均较差。我们的数据表明,一些 HLA 多态性影响 DLBCL 的发生和结果,允许确定一个极好的风险预后亚组。然而,这些结果是初步的,需要进一步验证,以排除可能的人群效应。

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