Cukrová V, Dolezalová L, Loudová M, Matĕjková E, Korínková P, Lukásová M, Starý J
Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
Neoplasma. 1995;42(1):3-8.
The usefulness of cytotoxic T lymphocytes precursors (CTLp) frequency analysis in the search for donors in bone marrow transplantation was studied. The frequency of anti-recipient CTLp was approached by limiting dilution assay in HLA matched unrelated, HLA partially matched related and HLA genotypically identical donors. The majority of patients examined were affected with different hematological malignancies. Alloreactive CTLp recognizing non-HLA gene products were not detected in pretransplant examination of two pairs of HLA identical siblings. However, an increased incidence of allospecific CTLp was identified in HLA matched MLC negative unrelated pairs. Thus, CTLp assay allowed to uncover the residual Class I incompatibilities that remained hidden in standard serotyping. In two matched unrelated pairs with high pretransplant CTLp frequency the severe acute graft-versus-host disease (GVHD) developed after bone marrow transplantation. Examination of other relatives in patients lacking an HLA identical sibling showed the importance of Class I incompatibility for CTLp generation as well. The lack of correlation between CTLp frequency and HLA-D disparity could suggest that Class II antigens do not participate in CTLp induction. With one exception we had good correlation between MLC and DNA analysis of Class II antigens demonstrating that MLC gives interpretable results even in unrelated pairs. Our results demonstrate the significance of CTLp frequency assay in detection of residual Class I incompatibilities in matched unrelated pairs and in assessment of Class I compatibility in related pairs. For that it should be used in the final selection of BMT donors.
研究了细胞毒性T淋巴细胞前体（CTLp）频率分析在骨髓移植供体寻找中的作用。通过有限稀释法测定HLA匹配的无关供体、HLA部分匹配的亲属供体和HLA基因分型相同的供体中抗受者CTLp的频率。大多数接受检查的患者患有不同的血液系统恶性肿瘤。在两对HLA相同的同胞移植前检查中未检测到识别非HLA基因产物的同种反应性CTLp。然而，在HLA匹配的MLC阴性无关供体对中发现同种特异性CTLp的发生率增加。因此，CTLp检测能够发现隐藏在标准血清分型中的残留I类不相容性。在两个移植前CTLp频率高的匹配无关供体对中，骨髓移植后发生了严重的急性移植物抗宿主病（GVHD）。对缺乏HLA相同同胞的患者其他亲属的检查也表明I类不相容性对CTLp产生的重要性。CTLp频率与HLA - D差异之间缺乏相关性可能表明II类抗原不参与CTLp的诱导。除了一个例外，我们在II类抗原的MLC和DNA分析之间有良好相关性，这表明即使在无关供体对中MLC也能给出可解释的结果。我们的结果证明了CTLp频率检测在检测匹配无关供体对中的残留I类不相容性以及评估亲属供体对中的I类相容性方面的重要性。因此，它应用于骨髓移植供体的最终选择。
