Kwok Janette, Guo Mengbiao, Yang Wanling, Ip Patrick, Lee C K, Lu Liwei, Chan Godfrey C F, Middleton Derek, van der Zanden Henk G M
Division of Transplantation and Immunogenetics, Queen Mary Hospital, Hong Kong.
Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong.
Hum Immunol. 2018 Jul;79(7):539-544. doi: 10.1016/j.humimm.2018.04.004. Epub 2018 Apr 13.
In Cord blood transplantation (CBT), the non-inherited maternal antigen (NIMA) virtual six HLA matched CB is found to have similar outcomes to six HLA inherited matched CB. Such virtual HLA matched CB units can be generated by substituting the inherited alleles with one to three NIMAs. In Hong Kong Cord Blood Bank, CB units have no NIMA defined. 100 CB samples were collected with NIMA defined. Retrospective searches of Hong Kong patients (n = 520) were matched against the inherited and virtual HLA phenotypes of NIMA CB file. One to three NIMA matches was analyzed, virtual six HLA matches were identified for 31.7% patients, 29.4% from CB units with 5/6 HLA match with 1 NIMA match and 1.7% CB units with a 4/6 HLA match and 2 NIMA matches. However, searches in the 167,201 Bone Marrow Donors Worldwide CB units with defined NIMA did not yield similar increases, possibly due to the ethnicity differences between populations. The match performance rises from 26% to 60% after including the NIMA match. Comparing the match performance of 32% in a previous Dutch study, we calculated with 60% matching in this smaller size study. This provides a solid ground to considering NIMA in stem cell donor selection which was adopted in some centers, to be extended to Asian and local CB registries to increase the chance for matches and also to improve patient outcomes, increase the utilization of CB units, enhance clinical flexibility and signify economic intelligence.
在脐血移植（CBT）中，发现非遗传的母体抗原（NIMA）虚拟六人类白细胞抗原（HLA）匹配的脐血与六HLA遗传匹配的脐血具有相似的结果。这种虚拟HLA匹配的脐血单位可以通过用一到三个NIMA替代遗传等位基因来产生。在香港脐血库，脐血单位未定义NIMA。收集了100份定义了NIMA的脐血样本。对香港患者（n = 520）进行回顾性搜索，并与NIMA脐血文件的遗传和虚拟HLA表型进行匹配。分析了一到三个NIMA匹配情况，31.7%的患者被鉴定为虚拟六HLA匹配，其中29.4%来自5/6 HLA匹配且有1个NIMA匹配的脐血单位，1.7%来自4/6 HLA匹配且有2个NIMA匹配的脐血单位。然而，在全球167,201个定义了NIMA的骨髓供体脐血单位中进行搜索，并未产生类似的增加，这可能是由于人群之间的种族差异。纳入NIMA匹配后，匹配成功率从26%提高到60%。与之前荷兰一项研究中32%的匹配成功率相比，在这项规模较小的研究中我们计算出匹配成功率为60%。这为在干细胞供体选择中考虑NIMA提供了坚实的基础，一些中心已经采用了这一做法，有望扩展到亚洲和当地的脐血登记处，以增加匹配机会，改善患者预后，提高脐血单位的利用率，增强临床灵活性并体现经济效益。
