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儿童恶性血液病化疗期间并发感染性休克9例临床分析
  • 期刊名称:中国实用儿科杂志
  • 时间:0
  • 页码:540-541
  • 语言:中文
  • 分类:R457.7[医药卫生—治疗学;医药卫生—临床医学] R758.63[医药卫生—皮肤病学与性病学;医药卫生—临床医学]
  • 作者机构:[1]中山大学附属第二医院干细胞研究中心,广州510120, [2]中山大学附属第二医院儿科,广州510120
  • 相关基金:国家自然科学基金资助项目(项目编号:30772367);广东省自然科学基金资助项目(项目编号:8151008901000099);广东省科技计划项目(项目编号:20088030301066)
  • 相关项目:NK细胞杀伤细胞性免疫球蛋白样受体在非血缘相关脐血移植中的免疫作用
中文摘要:

目的探讨HLA-Cw配型在异基因造血干细胞移植中与GVHD的发生和复发的关系。方法对HLA6个位点(A、B、DR/DQ)全相合的同胞供者9例异基因外周血干细胞移植和10例脐带血移植进一步进行HLA-Cw配型,分析HLA-Cw配型与GVHD发生的关系。结果16例HLA-Cw相合者,共植入15例(94%),其中Ⅰ-Ⅱ度急性GVHD发生11例(69%),Ⅲ度急性GVHD2例(12.5%),慢性GVHD15例(94%),无复发病例。在HLA—Cw不相合3例中,2例发生Ⅲ度GVHD并且早期死亡,1例早期复发。在HLA—Cw配型相合与不相合两组间,急性Ⅰ~Ⅱ度及Ⅲ度GVHD的发生其差异均具有统计学意义(P〈0.05)。结论HLA—Cw配型相合供体造血干细胞移植有利于减少植入后急性GVHD发生及复发,提示HLA-Cw位点配型在造血干细胞移植,尤其是异基因移植中具有重要意义。

英文摘要:

Objective To determine the effects of HLA-Cw typing on graft-versus-host disease and relapse after allogeneic hematopoietic stem cell transplantation. Methods HLA - Cw typing was performed in HLA identical allogeneic hematopoietic stem cell transplantation,including 9 patients with allogeneic peripheral blood stem cell transplantation(allo-PBSCT) and 10 patients with umbilical cord blood(UCBT) respectively. Acute GVHD data were compared between the groups with different HLA-Cw typing results ( matched and unmatched). Results In 16 HLA-Cw matched patients, 15 cases got engrafted(94% ), and 11 patients had Ⅰ~Ⅱ acute GVHD and 2 patients had Ⅲ acute GVHD. Fifteen patients had chronic GVHD but no patients had relapse. In 3 HLA-Cw unmatched patients,2 patients had Ⅲ acute GVHD and died in early stage and 1 patient had early relapse. When cases were classified into two groups accoring to HLA-Cw typing results, there is statistically significant difference in both Ⅰ~Ⅱ and Ⅲ acute GVHD between these two groups(P 〈0. 05). Conclusion In hematopoietic stem cell transplantation cases, HLA-Cw matching may be helpful to reduce GVHD. The results suggest that HLA typing is important for the prognosis of hematopoietic stem cell transplantation in addi- tion to HLA-A, B,DR/DQ matching.

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