供者特异性抗体在异基因造血干细胞移植中的研究进展

Donor-Specific Antibodies in Allogeneic Hematopoietic Stem Cell Transplantation——Review

胞在allo-HSCT中较为常见。部分患者移植前或移植后存在供者特异性抗体,此类抗体可能引起植入失败和造血恢复延迟等移植并发症,影响患者的移植效果。识别供者特异性抗体的高危人群并对高危人群进行抗体检测,对于抗体阳性的患者进行及时的干预对于改善HLA不全相合造血干细胞移植的效果有重要意义。本文就供者特异性抗体流行病学、风险因素、供者特异性抗体对于非亲缘供者及单倍体相合HSC供者的allo-HSCT的影响、供者源的抗HLA抗体对于移植的影响以及供者特异性抗体的脱敏治疗做一综述。

Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is widely used in the treatment of hematological diseases,HLA incompatibility is displayed in most cases.Some patients have prestored donor-specific antibodies(DSA)or new emerging antibodies after transplantation.Donor-specific antibodies may cause graft failure and poor graft function,and affect transplant outcome.It is important to identify high risk candidates,assay antibodies and give proper intervention for improving the outcome of allo-HSCT.In this review,the research progress of DSA in allo-HSCT is summarized,including DSA prevalence,risk factors,the role of prestored DSA in unrelated and haploidentcal HSCT,the effect of donor derived antibodies in transplantation and desensitization therapy.