无关供者造血干细胞移植中活化型KIR的作用

Role of activated donor killer cell immunoglobulin-like receptor in transplantation of peripheral stem cells from unrelated donors

目的探讨杀伤细胞免疫球蛋白样受体(killer cell immunoglobulin-like receptor,KIR)在无关供者中的分布及对无关供者造血干细胞移植预后的影响。方法采用序列特异性引物PCR(PCR-SSP)分型技术检测HLA及KIR基因型。检测了30例无关供者中KIR的基因型分布、30例无关供者造血干细胞移植供受者对KIR及HLA基因型,并对15例接受HLA相合、非去除T细胞无关供者造血干细胞移植(HSCT)的恶性血液病患者病例资料进行回顾性分析。结果检测的30例HLA相合无关供者造血干细胞移植中,24例患者KIR2DL1不合,2例KIR2DL2/2DL3不合,12例KIR3DL1不合,共计28例患者KIR不合。无关供者造血干细胞移植中,5个活化型KIR阳性组生存时间明显延长。结论绝大多数无关供者携带与无关供者造血干细胞移植关系密切的三组KIR,无关供者造血干细胞移植中5个活化型KIR阳性组生存时间明显延长。

Objective To investigate the distribution of killer cell immunoglobulin-like receptor （KIR） genes in unrelated blood donors and its effect on the prognosis after transplantation of peripheral stem cells from unrelated donors. Methods HLA and KIR genotypes were detected by sequence specific primer-polymerase chain reaction （PCR-SSP）. The distribution of KIR and HLA genotypes was detected in 30 unrelated blood donors and in 30 recipients of stern cell transplantation, respectively. A retrospective study was carried out to analyze the outcomes of non T cell-depleted hematopoietic stem cell transplantation （HSCT） in 15 HLA- matched patients with various hematological malignancies. Results KIR2DL1, KIR2DL2/2DL3, and KIR3DL1 were not matched, respectively, in 24, 2, and 1 of the 30 HLA-matched patients after transplantation of hematopoietic stem cells from unrelated donors. The survival time of patients with 5 activated KIR genotypes was significantly longer than that of other genotypes （P=0.002）. Conclusion The majority of unrelated donors carry KIR genotypes which are closely related with transplantation of hematopoietic stem cells. The survival time in patients of 5 activated K1R genotypes is significantly longer than that of other genotypes.