Cunha R, Loiseau P, Ruggeri A, Sanz G, Michel G, Iori A P, Socié G, Arcese W, Picardi A, Dias de Heredia C, Rio B, Locatelli F, O'Brien T A, Yakoub-Agha I, Angel Diaz M, Milpied N, Bittencourt H, Pedro Souza M, Aljurf M, Charron D, Boudjedir K, Labopin M, Gluckman E, Rocha V
Eurocord, Hôpital Saint Louis, Paris, France.
Service d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, AP-HP and Inserm UMRS940, Paris, France.
Bone Marrow Transplant. 2014 Jan;49(1):24-9. doi: 10.1038/bmt.2013.120. Epub 2013 Aug 19.
HLA matching is a critical determinant of outcomes for patients who have undergone umbilical cord blood transplantation (UCBT). Data have been published on the importance of donor/recipient HLA mismatch direction on UCBT outcomes. HLA mismatch in the graft-versus-host (GVH) direction is defined as a donor homozygous at an HLA locus, while the recipient shares one HLA Ag with the donor. HLA mismatch in the host-versus-graft (HVG) direction is defined as a recipient homozygous with the donor sharing one HLA Ag. In our study we focused on confirming, using an independent population, whether transplantation outcomes would be different when HLA mismatch direction was considered. We analyzed 1565 patients who received a single-unit UCBT for malignant disease. Median age was 15 years and 72% of patients were transplanted for leukemia. In multivariate analysis, using the 5/6 HLA-matched population as reference, one or two HLA mismatches in the GVH or HVG direction were not associated with non-relapse related mortality and survival. On the basis of our results, there is no evidence to support a change in the current practice for cord blood unit selection.
对于接受脐带血移植（UCBT）的患者而言，人类白细胞抗原（HLA）配型是决定移植结果的关键因素。关于供体/受体HLA错配方向对UCBT结果的重要性，已有相关数据发表。移植物抗宿主（GVH）方向的HLA错配定义为供体在某个HLA位点为纯合子，而受体与供体共享一个HLA抗原。宿主抗移植物（HVG）方向的HLA错配定义为受体为纯合子，供体与受体共享一个HLA抗原。在我们的研究中，我们聚焦于通过一个独立人群来确认，当考虑HLA错配方向时移植结果是否会有所不同。我们分析了1565例因恶性疾病接受单单位UCBT的患者。中位年龄为15岁，72%的患者因白血病接受移植。在多变量分析中，以5/6 HLA相合人群作为参照，GVH或HVG方向的一两个HLA错配与非复发相关死亡率和生存率无关。基于我们的研究结果，没有证据支持改变目前脐带血单位选择的做法。
