HLA-loss参与单倍体相合移植后白血病复发的机制

The mechanism of HLA-loss participating in leukemia relapse after haploidentical transplantation

单倍体相合造血干细胞移植(haploidentical hematopoietic stem cell transplantation,haplo-HSCT)的快速发展有效解决了供者来源的问题,逐渐成为高危急性髓系白血病(acute myeloid leukemia,AML)患者的主要治疗方法之一^([1]),可以用于治疗有移植指征但缺乏人类白细胞抗原相匹配或需要紧急移植的恶性血液病患者。

The loss of HLA molecule expression on tumor cells is one of the characteristics of immune escape.HLA-loss,genomic loss of a mismatched HLA haplotype,contributes to the escape of residual leukemic cells from immune surveillance and killing effect of donor T cells and thus induces leukemia relapse after haploidentical transplantation.HLA-loss has important clinical significance.It not only invalidates donor lymphocyte infusions used for prevention and treatment of post-transplantation relapse,but also increases the risk of graft versus host disease.This review focus on recent research of HLA-loss involved in relapse after haploidentical transplantation,which provides effective exploration on early diagnosis and treatment strategies for post-transplantation leukemia relapse.