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。
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.