Kanda Junya
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University.
Rinsho Ketsueki. 2017;58(12):2415-2424. doi: 10.11406/rinketsu.58.2415.
Human leukocyte antigen (HLA) mismatch increases the risk of severe graft-versus-host disease (GVHD) and transplant-related mortality. However, the variety of stem cell sources such as cord blood units or the improvements in GVHD prophylaxis makes the interpretation of HLA mismatch more complex. In unrelated transplantation, the locus of HLA mismatch has a great impact on the donor candidate selection, whereas in related transplantation, it has an impact on the intensity of GVHD prophylaxis because donor availability is limited. Anti-thymocyte globulin and post-transplant cyclophosphamide are attractive GVHD prophylactic agents to reduce the risk of immune-associated complications in HLA-mismatched transplantations. HLA mismatch has a reduced impact in adult cord blood transplantation. In this review article, the impact of HLA mismatch based on graft sources is discussed.
人类白细胞抗原（HLA）不匹配会增加严重移植物抗宿主病（GVHD）和移植相关死亡率的风险。然而，诸如脐血单位等多种干细胞来源或GVHD预防措施的改进使得对HLA不匹配的解读更加复杂。在非亲缘移植中，HLA不匹配的位点对供体候选者的选择有很大影响，而在亲缘移植中，由于供体来源有限，它对GVHD预防的强度有影响。抗胸腺细胞球蛋白和移植后环磷酰胺是有吸引力的GVHD预防药物，可降低HLA不匹配移植中免疫相关并发症的风险。HLA不匹配在成人脐血移植中的影响较小。在这篇综述文章中，将讨论基于移植物来源的HLA不匹配的影响。
