Department of Internal Medicine, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
HLA. 2020 Oct;96(4):445-455. doi: 10.1111/tan.13966. Epub 2020 Aug 4.
Some HLA alleles have been shown to be associated with susceptibility to cytomegalovirus (CMV) disease incidence in vitro. The objective of this study was to identify correlations between donor HLA allotypes and CMV disease incidence in patients with acute myeloid leukemia who had undergone allogeneic hematopoietic stem cell transplantation (HSCT). Methods and materials we retrospectively analyzed the medical records of 613 donors and recipients with acute myeloid leukemia who had received an allogeneic HSCT from matched sibling (n = 260), unrelated (n = 168), or haploidentical (n = 186) donors, from 2012 to 2017. The HLA-A, -B, -C, and -DRB1 allotypes in the donors were determined using sequence-based typing. Overall, CMV disease incidence was significantly associated with three genotype alleles, HLA-A30:04:01G, -B51:01:01G, and -DRB109:01:02G. In the donor CMV IgG seropositive subgroup, CMV disease incidence was significantly associated with HLA-B51:01:01G and -DRB109:01:02G. In the IgG seropositive donors in the unrelated allo-HSCT subgroup CMV disease incidence was also significantly associated with HLA-B51:01:01G. In the CMV seropositive donors in the haploidentical allo-HSCT subgroup, the incidence of CMV disease was significantly associated with HLA-A24:02:01G and -DRB109:01:02G. HLA-DRB1*13:02:01G was a protective marker among IgG seropositive donors in the unrelated allo-HSCT recipient category. Discussion and conclusions The incidence of CMV disease among HSCT recipients varies according to donor HLA alleles and the donor CMV IgG serostatus. Certain donor HLA alleles can be considered to be risk or protective markers. Donors' HLA types and CMV IgG serostatus should be considered in donor selection.
一些 HLA 等位基因已被证明与体外巨细胞病毒 (CMV) 疾病发病易感性相关。本研究的目的是确定供体 HLA 同种型与接受异基因造血干细胞移植 (HSCT) 的急性髓细胞白血病患者 CMV 疾病发病之间的相关性。
方法和材料 我们回顾性分析了 2012 年至 2017 年间接受同胞 (n = 260)、无关 (n = 168) 或单倍体 (n = 186) 供体异基因 HSCT 的 613 名急性髓细胞白血病供体和受者的病历。使用基于序列的分型方法确定供体中的 HLA-A、-B、-C 和 -DRB1 同种型。总体而言，CMV 疾病发病率与三个基因型等位基因 HLA-A30:04:01G、-B51:01:01G 和 -DRB109:01:02G 显著相关。在供体 CMV IgG 血清阳性亚组中，CMV 疾病发病率与 HLA-B51:01:01G 和 -DRB109:01:02G 显著相关。在无关异体 HSCT 亚组的 IgG 血清阳性供体中，CMV 疾病发病率也与 HLA-B51:01:01G 显著相关。在单倍体异体 HSCT 亚组的 CMV 血清阳性供体中，CMV 疾病的发生率与 HLA-A24:02:01G 和 -DRB109:01:02G 显著相关。HLA-DRB1*13:02:01G 是无关异体 HSCT 受者 IgG 血清阳性供体中的保护性标志物。
讨论和结论 HSCT 受者 CMV 疾病的发病率因供体 HLA 等位基因和供体 CMV IgG 血清阳性状态而异。某些供体 HLA 等位基因可被视为风险或保护标志物。在供体选择时应考虑供体的 HLA 类型和 CMV IgG 血清阳性状态。
