白血病患者与非亲缘造血干细胞供者的HLA-Cw基因高分辨分型  

High resolution nmtching of HLA-Cw and effect on unrelated blood stem cell transplantation in acute leukemia

作　　者：何军[1] 陈子兴[1] 侯建全[1] 吴德沛[1] 鲍晓晶[1] 姚利[1] 袁晓妮[1] 岑建农[1] 邱桥成[1] 狄文英 张辉[2] 张健[2] 周晓华[2] 徐惠新[2] 

机构地区：[1]中国造血干细胞捐献者资料库HLA高分辨配型定点实验室苏州大学附属第一医院江苏省血液研究所,苏州215006 [2]苏州市红十字中心血站

出　　处：《中华器官移植杂志》2008年第3期152-154,共3页Chinese Journal of Organ Transplantation

基　　金：卫生部科研基金（wkj20062-023）;江苏省卫生厅135开放项目（K0611）;江苏省六大人才高峰（07821）;江苏省高校自然科学基金（07kj320106）;苏州市中外国际合作项目（SWH0716）

摘　　要：目的 对白血病患者与非亲缘造血干细胞供者进行HLA-Cw基因高分辨分型，探讨供、受者的相合几率。方法 用序列特异性引物聚合酶链反应（PCR-SSP）联合序列特异性寡核苷酸探针（PCR-SSOP）方法进行HLA高分辨分型，依据分型结果将78例白血病患者与来自中国造血干细胞捐献者资料库中的126名供者进行配对，选择配合最佳者。结果 21例急性淋巴细胞白血病（ALL）患者中，HLA-Cw高分辨分型的常见基因型为Cw＊0102、Cw＊0304、Cw＊0302、Cw＊0702和Cw＊0801，其表型频率分别为0．57、0．33、0．19、0．14和0．14；ALL患者的Cw＊0102和Cw＊0304的表型频率明显高于捐献者（P〈0．05）；7例患者（33．3％，7／21）的10个等位基因与捐献者全相合，HLA-Cw全相合常见的基因亚位点依次为Cw＊0102（4／7）、Cw＊0702（2／7）。34例慢性粒细胞白血病（ALL）患者中，HLA-Cw高分辨分型的常见基因型为Cw＊0702、Cw＊0102、Cw＊0304、Cw＊0801、Cw＊0401和Cw＊0303，其表型频率分别为0．44、0．38、0．21、0．18、0．15和110．12；与捐献者相比，CML患者各基因型的表型频率的差异均无统计学意义；8例患者（23．5％，8／34）的10个等位基因与捐献者全相合，HLA-Cw全相合常见的基因亚位点依次为Cw＊0702（5／8）、Cw＊0304（3／8）。23例急性髓系白血病（AML）患者中，4例的10个等位基因与捐献者全相合，其原发病均为AML-M2型。结论 ALL患者和捐献者的Cw＊0102和Cw＊0304基因表型频率较高，有利ALL患者寻找到HLA-Cw相合的供者。Objective To study high resolution typing of HLA-Cw and its effect on unrelated blood stem cell transplantation （BMT） in acute leukemia. Methods High resolution HLA-Cw analysis was performed on 78 patients （21 cases of ALL, 34 cases of CML, 23 cases of AML） from the data base of China Marrow Donor Program by using PCR-SSP and PCR-SSOP. Results In ALL patients, the HLA-Cw with common gene site was Cw ＊01（12, Cw ＊ 03（14, Cw ＊ 0302, Cw ＊ 0702, Cw＊ 0801, and the phenotype frequencies were 0. 57, 0. 33, 0. 19, 0. 14 and 0. 14 respectively. The differences between these phenotype frequencies of Cw ＊ 0102 and Cw ＊ 0304 were statistically significant in ALL and donors （P〈0. 05）. Seven ALL patients （7/21） and donors were matched with loci in HLA-A, B, Cw, DRB1, DQB1, among which Cw ＊ 0102 was the subsites with highest frequency, followed by Cw ＊ 0702. In CML patients, the HLA-Cw with common gene site was Cw ＊ 0702, Cw ＊ 0102, Cw ＊ 0304, Cw ＊ 0801, Cw ＊ 0401, Cw＊0303, and the phenotype frequencies were 0. 44, 0.38, 0. 21, 0. 18, 0. 15, 0. 12 respectively, with the differences between these phenotype frequencies being not statistically significant （P〈0. 05）. Eight CML patients （8/32） and donors were matched with loci in HLA-A, B, Cw, DR and DQ, among which Cw ＊ 0702 was the subsltes with highest frequency, followed by Cw ＊ 0304. All of the 4 M2 patients and donors were matched with loci in 23 cases of AML. Conclusion Cw ＊ 0102 and Cw ＊ 0304 have the obviously highest phenotype frequencies in ALL, which is beneficial for the selection of HLA-Cw matched donors.

关 键 词：HLA-C抗原 组织相容性试验 造血干细胞移植 白血病 

分 类 号：R733.7[医药卫生—肿瘤]