[供者杀伤细胞免疫球蛋白样受体（KIR）受体人白细胞抗原（HLA）的遗传背景与HLA全相合同胞造血干细胞移植结局的关系]

[Relationship between the genetic background of donor KIR recipient HLA and the outcomes in HLA-identical sibling HSCT].

作者信息

Ma Hong-jing, Yin Xiao-lin, Guo Kun-yuan, Xiao Lu-lu, Ye Xin

机构信息

Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2006 Feb;27(2):91-4.

PMID:16732960

Abstract

OBJECTIVE

To explore the relationship between the genetic background of donor KIR/recipient HLA and the outcomes in HLA-identical sibling HSCT.

METHODS

HLA genotype was determined by polymerase chain reaction-sequence-specific oligonucleotide probes (PCR-SSOP) and/or PCR-sequence-specific primer (PCR-SSP). Donor KIR genotype was determined by PCR-SSP. A retrospective study was carried out to analyze the outcomes of 59 patients with various hematologic malignancies received non T-cell-depleted transplant from HLA-identical sibling donors.

RESULTS

Incidence of grade II-IV acute graft-versus-host disease (aGVHD) was significantly lower in patients of KIR/HLA matched group than in KIR/HLA mismatched group (32% vs 78%, P = 0.026). The incidence of grade II-IV aGVHD (24% vs 61%, P = 0.018) and fungus infection (14% vs 44%, P = 0.028) were significantly lower in Bw4 matched group than in Bw4 mismatched group. In myeloid diseases, Bw4 matched patients had much lower incidence of fungus infection (12% vs 80%, P = 0.002) compared with Bw4 mismatched patients, and C2 matched patients had higher overall survival (OS) compared with C2 mismatched patients (P = 0.01).

CONCLUSIONS

Donor KIR/recipient HLA genetic background is correlated with the outcomes of HLA-identical sibling HSCT in incidences of grade II-IV aGVHD, fungus infection and OS. KIR/HLA matched patients may have lower incidence of aGVHD. Bw4 matched patients may have lower incidences of aGVHD and fungus infection. C2 matched patients may have longer OS.

摘要

目的

探讨供者杀伤细胞免疫球蛋白样受体（KIR）/受者人类白细胞抗原（HLA）的遗传背景与HLA全相合同胞造血干细胞移植（HSCT）结局之间的关系。

方法

采用聚合酶链反应-序列特异性寡核苷酸探针（PCR-SSOP）和/或聚合酶链反应-序列特异性引物（PCR-SSP）检测HLA基因型。采用PCR-SSP检测供者KIR基因型。对59例接受HLA全相合同胞供者非T细胞去除移植的各种血液系统恶性肿瘤患者的结局进行回顾性研究。

结果

KIR/HLA匹配组患者Ⅱ-Ⅳ度急性移植物抗宿主病（aGVHD）的发生率显著低于KIR/HLA不匹配组（32%对78%，P = 0.026）。Bw4匹配组Ⅱ-Ⅳ度aGVHD的发生率（24%对61%，P = 0.018）和真菌感染率（14%对44%，P = 0.028）显著低于Bw4不匹配组。在髓系疾病中，与Bw4不匹配患者相比，Bw4匹配患者的真菌感染率低得多（12%对80%，P = 0.002），C2匹配患者的总生存期（OS）高于C2不匹配患者（P = 0.01）。