Zhou Yang, Chen Yu-Lun, Huang Xi-Yi, Chang Ying-Jun
Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital &, Peking University Institute of Hematology, No. 11 South Street of Xizhimen, Xicheng District, Beijing, 100044, China.
Department of Experimental Medicine, School of Public Health, Xiamen University, Xiamen, People's Republic of China.
Oncol Ther. 2024 Sep;12(3):375-394. doi: 10.1007/s40487-024-00283-6. Epub 2024 Jun 15.
In human leukocyte antigen (HLA)-mismatched allogeneic stem cell transplantation settings, donor-specific anti-HLA antibodies (DSAs) can independently lead to graft failure, including both primary graft rejection and primary poor graft function. Although several strategies, such as plasma exchange, intravenous immunoglobulin, rituximab, and bortezomib, have been used for DSA desensitization, the effectiveness of desensitization and transplantation outcomes in some patients remain unsatisfactory. In this review, we summarized recent research on the prevalence of anti-HLA antibodies and the underlying mechanism of DSAs in the pathogenesis of graft failure. We mainly focused on desensitization strategies for DSAs, especially novel methods that are being investigated in the preclinical stage and those with promising outcomes after preliminary clinical application.
在人类白细胞抗原（HLA）配型不合的异基因干细胞移植情况下，供体特异性抗HLA抗体（DSA）可独立导致移植物失败，包括原发性移植物排斥和原发性移植物功能不良。尽管已经采用了多种策略，如血浆置换、静脉注射免疫球蛋白、利妥昔单抗和硼替佐米进行DSA脱敏，但部分患者的脱敏效果和移植结局仍不尽人意。在本综述中，我们总结了近期关于抗HLA抗体的流行情况以及DSA在移植物失败发病机制中的潜在机制的研究。我们主要关注DSA的脱敏策略，特别是正在临床前阶段研究的新方法以及初步临床应用后取得有前景结果的方法。
