HLA-C_W基因分型在造血干细胞移植中的意义探讨

A study on the significance of HLA- C_W typing in hematological stem cell transplantation

目的探讨HLA-CW位点基因分型在造血干细胞移植(hematopoiceticstemcelltrans-plantation-HSCT)中的作用,对HLA-CW基因位点相合与不相合造血干细胞移植的效果进行分析。方法采用聚合酶链反应-序列特异性引物扩增(polymerasechainreaction-sequencespecificprimers,PCR-SSP)方法对HSCT供、受体共42个样本进行HLA-CW位点等位基因分析。结果HLA-CW基因全相合者9例造血重建,存活200d以上7例,1例存活303d复发,2例存活44d(死于感染),无病生存率(66.7±3.4)%。1例(11.1%)发生急性移植物抗宿主病(aGVHD),3例(33.3%)发生慢性移植物抗宿主病(cGVHD)。HLA-CW基因不相合者12例造血重建,存活200d以上6例,1例存活105d复发,6例存活75d死亡,无病生存率(41.7±5.4)%(P<0.05)。6例(50%)发生aGVHD;5例(41.7%)发生cGVHD(P>0.05)。结论HLA-CW基因不相合导致的aGVHD及相关死亡率明显高于CW基因相合者,显示CW基因不相合也是造成aGVHD发生率增高和影响移植效果的重要因素。

Objective To study on the significance of HLA- CW resolution typing method in hematological stem cell transplantation and to analyze the effect of HLA- CW alleles donors and recipients. Methods Polymerase chain reaction- sequence specific primers PCR- SSP typing were employed to type 36 cases of related hematopoietic stem cell transplantation donors and recipients. Results 9 HLA- CW alleles entirely matching were engrafted successfully. 7 of them survived over 200 days, The rate of disease free survival is (66.7±3.4) %, 1 patient (11.3 %) got aGVHD, and 3 patients(33.3 %) got cGVHD. 12 HLA- CW alleles mismatching. 6 of them survived over 200 days, The rate of disease free survival is (41.7±5.4)% (P < 0.05). 6 patients got aGVHD (41.7 %), and 5 patients (41.7 %) got cGVHD (P > 0.05). Conclusions The aGVHD and related death rate of HLA- CW alleles mismatching significantly higher than those matching pairs, which reflects that the disparity of HLA- CW alleles is an important reason of aGVHD and would significantly affect HSCT results.