Department of Hematology, Internal Medicine Division, Hospital Universitario "Dr. José E. González", School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico.
Rev Invest Clin. 2020;72(2):69-79. doi: 10.24875/RIC.19003215.
The impact of HLA-DPB1 compatibility and its role as a transplantation antigen in haploidentical-related hematopoietic stem cell transplant (haplo-R-HSCT) have not been established, and a negative effect on survival has been suggested.
The objective of the determine was to study the frequency and clinical effects of incompatibility at the HLA-DPB1 locus in the haplo-R-HSCT setting.
Clinical records and electronic files of 91 patients with a hematological disease who underwent haplo-HSCT from January 2009 to October 2017 in a university medical center were scrutinized. Overall survival (OS) was estimated by the Kaplan-Meier method; the cumulative incidence of transplant-related mortality (TRM) and relapse rates was determined. Acute graft-versus-host disease was assessed by binary logistic regression. Cox regression model with a 95% confidence interval was used to examine the association between the different variables and their effect on OS.
Of the 91 donor-recipient pairs, 24 (26.37%) shared complete DPB1 identity, 60 (65.93%) had a mismatch at one allele, and 7 (7.70%) were mismatched at two alleles. Twenty-four different HLA-DPB1 alleles were found; the most frequent were DPB104:01 (34.1%) and DPB104:02 (27.5%). Two-year OS, the cumulative incidence of TRM and relapse was 51.3 ± 6.8%, 28 ± 6% and 60 ± 7.8% for all haplo-related transplants, respectively, with no statistical difference between HLA-DPB1 matched and partially matched patients. In Cox regression analysis, no risk factors associated with OS, TRM, or relapses were identified.
HLA-DPB1 mismatching in the haplo-R-HSCT setting did not influence transplant outcomes and was clinically tolerable. A high degree of homozygosity was found.
HLA-DPB1 配型的影响及其作为单倍体相关造血干细胞移植（haplo-R-HSCT）中移植抗原的作用尚未确定，并且有人提出其对存活率有负面影响。
本研究旨在研究 HLA-DPB1 基因座不合在单倍体-R-HSCT 背景下的频率和临床影响。
回顾性分析 2009 年 1 月至 2017 年 10 月在一所大学医学中心接受单倍体 HSCT 的 91 例血液病患者的临床记录和电子病历。采用 Kaplan-Meier 法估计总生存率（OS）；确定移植相关死亡率（TRM）和复发率的累积发生率。采用二项逻辑回归评估急性移植物抗宿主病。采用 Cox 回归模型和 95%置信区间检验不同变量之间的关系及其对 OS 的影响。
在 91 对供受者中，24 对（26.37%）完全共享 DPB1 同一性，60 对（65.93%）在一个等位基因上不匹配，7 对（7.70%）在两个等位基因上不匹配。发现 24 种不同的 HLA-DPB1 等位基因，最常见的是 DPB104:01（34.1%）和 DPB104:02（27.5%）。所有单倍体相关移植的 2 年 OS、TRM 累积发生率和复发率分别为 51.3±6.8%、28±6%和 60±7.8%，HLA-DPB1 匹配和部分匹配患者之间无统计学差异。Cox 回归分析未发现与 OS、TRM 或复发相关的危险因素。
在单倍体-R-HSCT 背景下，HLA-DPB1 不匹配不影响移植结果且具有临床耐受性。发现高度同型性。
