摘要
目的分析NK细胞免疫球蛋白样受体(KIR)B/X基因型对无关供者HLA全相合造血干细胞移植患者预后的影响。方法采用序列特异性引物聚合酶链反应(SSP.PCR)和序列特异性寡核苷酸探针聚合酶链反应(SSOP-PCR)的方法,对52对HLA全相合供.受者进行KIR与HLA分型.患者中急性淋巴细胞白血病(ALL)22例,急性髓系自血病(AML)13例,慢性粒细胞白血病(CML)15例,骨髓增生异常综合征(MDS)l例,急性杂合型白血病(HAL)l例。结果①28例供者KIR基因型为B/X,24例供者KIR基因型为A/A。②KIR基因型B/X组患者移植后中性粒细胞和血小板的重建时间与A/A基因型组相比差异无统计学意义(P〉0.05);两者的Ⅲ^。-Ⅳ^。急性GVHD(10.7%VS20.8%,P=-0.266)和慢性GVHD(53.6%Vs29.2%,P=0.067)之间的差异无统计学意义。B/X基因型组患者移植后3年持续缓解率(70.7%VS62.5%.P=0.414)和3年总生存率(75.5%VS62.5%,P=0.194)高于A/A组,但差异无统计学意义。结论在无关供者HLA全相合造血干细胞移植中,供者KIR基因型B/X可能增加了患者慢性GVHD的发生率,对持续缓解率和总生存率无明显影响。
Objective To analyze the prognostic impact of KIR B/X genotype in HLA-matched hematopoietic stem cell transplantation(HSCT) using unrelated donor.Methods HLA genotype of 52 patients(ALL 22 cases,AML 13 cases,CML 15 cases,MDS 1 case and HAL I case) and their matched unrelated donors was determined by polymerase chain reaction sequence oligonucleotide probes(PCR-SSOP) and sequence specific primers(PCR-SSP).The KIR genotype was determined by PCR-SSEResults Donors were divided into those(n=28) with KIR B/X genotype and those(n=24) with KIR A/A genotype.There was no significant difference in neutrophil and platelet recovery, llIo . iV o acute GVHD(10.7% vs 20.8%,P=0.266) and chronic GVHD(53.6% vs 29.2%,P--0.067) between the two groups of patients after transplantation from KIR B/X donors and KIR A/A donors.The 3-year continuous complete remission(CCR) rate for patients using B/X donors and using A/A donors was 70.7% and 62.5%,respectively(P=0.414).The 3-year overall survival(OS) rate for the two groups was 75.5% and 62.5%,respectively(P=0.194).Conclusions In HLA-matched unrelated donor HSCT, KIR B/X genotype of donors might be associated with increased chronic GVHD,but have no si~,nificant influence on CCR and OS
出处
《中国血液流变学杂志》
CAS
2011年第4期565-568,共4页
Chinese Journal of Hemorheology
基金
江苏高校优势学科建设工程资助项目
“六大人才高峰”第五批高层次人才资助项目
关键词
杀伤细胞免疫球蛋白样受体
全相合无关供者
造血干细胞移植
killer cell immunoglobulin like receptor(KIR)
Matched unrelated donor
Hematopoietic stemcell transplantation