Yang Shuo, He Jun, Li Yang, Xu Chao, Bao Xiao-Jing, Yuan Xiao-Ni, Qiu Hui-Ying, Jin Zheng-Ming, Tang Xiao-Wen, Fu Cheng-Cheng, Han Yue, Ma Xiao, Wu De-Pei, Sun Ai-Ning
Jiangsu Instiute of Hematology, The First Affiliated Hospial of Soochow University; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, Jiangsu Province, China.
Jiangsu Instiute of Hematology, The First Affiliated Hospial of Soochow University; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, Jiangsu Province, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2014 Feb;22(1):125-30. doi: 10.7534/j.issn.1009-2137.2014.01.025.
This study was purposed to investigate the clinical value of HLA matching(low and high resolution) and its effect on outcome of the patients received umbilical cord blood transplantation(UCBT). Sequence-specific oligonucleotide probe (SSOP) , sequence-based typing (SBT) and sequence-specific primers(SSP) were used to perform high resolution HLA matching for HLA-A, -B, -Cw, -DRB1, -DQB1 and low resolution for HLA-A, B, DRB1 among 34 patients with hematologic malignancies who received unrelated UCB transplantation and grafts. The effects of HLA matching (low or high resolution ) on leading engraftment, hematopoietic reconstitution, graft-versus-host disease (GVHD) and infection after UCB transplantation were analyzed by comparison. The results showed that the median of total nucleated cells (TNC) of transplanted cord blood was 6.0×10(7)/kg, The time of neutrophil recovery was significantly shortened when more than 5×10(7)/kg TNC were transplanted (P < 0.05). The HLA-(6-10)/10 group of high resolution HLA matching was better than the HLA (4-5)/10 group in the respect of leading engraftment, the time of platelet recovery and the rate of acute GVHD (P < 0.05). In contrast, HLA-I+II locus, HLA-DRB1 or HLA-DQB1 locus mismatch could prolong the platelet engraftment time (P < 0.05). There was statistical difference in the time of platelet recovery, the rate of acute GVHD between the HLA (5-6)/6 group of low resolution HLA matching and the HLA (3-4)/6 group after UCB transplantation (P < 0.05), but the mismatch locus of HLA with low resolution did not correlate with the time of platelet recovery (P > 0.05). It is concluded that the high resolution HLA matching between patients received unrelated UCB transplantation and grafts may contribute to select the better UCB, that has important clinical value to promote hematopoietic reconstitution and to reduce the complications after UCB transplantation.
本研究旨在探讨人类白细胞抗原（HLA）配型（低分辨率和高分辨率）的临床价值及其对接受脐带血移植（UCBT）患者预后的影响。采用序列特异性寡核苷酸探针（SSOP）、序列分型（SBT）和序列特异性引物（SSP）对34例接受非亲缘脐血移植及移植物的血液系统恶性肿瘤患者进行HLA-A、-B、-Cw、-DRB1、-DQB1的高分辨率HLA配型及HLA-A、B、DRB1的低分辨率配型。通过比较分析HLA配型（低分辨率或高分辨率）对脐血移植后造血干细胞植入、造血重建、移植物抗宿主病（GVHD）及感染的影响。结果显示，移植脐血有核细胞总数（TNC）中位数为6.0×10⁷/kg，当移植TNC超过5×10⁷/kg时，中性粒细胞恢复时间明显缩短（P<0.05）。高分辨率HLA配型的HLA-(6-10)/10组在造血干细胞植入、血小板恢复时间及急性GVHD发生率方面优于HLA(4-5)/10组（P<0.05）。相反，HLA-I+II位点、HLA-DRB1或HLA-DQB1位点错配可延长血小板植入时间（P<0.05）。低分辨率HLA配型的HLA(5-6)/6组与HLA(3-4)/6组在脐血移植后血小板恢复时间、急性GVHD发生率方面存在统计学差异（P<0.05），但低分辨率HLA错配位点与血小板恢复时间无关（P>0.0５）。结论：接受非亲缘脐血移植及移植物患者间的高分辨率HLA配型有助于选择更好的脐血，对促进造血重建及减少脐血移植后并发症具有重要临床价值。
