应用不同类型白血病患者群体HLA-A、B和DRB1遗传学数据评估HLA相合供者的概率  

Study on HLA-A,B and DRB1 matching probability donors for Chinese Han leukemia patients

作　　者：高素青[1] 程良红[1] 朱为刚[1] 卢亮[1] 杨宝成[1] 邓志辉[1] 

机构地区：[1]深圳市血液中心深圳市输血医学研究所,广东深圳518035

出　　处：《中国输血杂志》2009年第5期358-362,共5页Chinese Journal of Blood Transfusion

基　　金：深圳市科技计划项目(编号:200603202);中华骨髓库合作项目(编号:20060825)资助课题

摘　　要：目的探讨不同类型白血病汉族患者群体找到HLA-A、B和DRB1低分辨全相合无关供者可能性。方法依据1201名急性淋巴细胞白血病(ALL)、1065名急性非淋巴细胞白血病(AML)和1432名慢性粒细胞白血病(CML)汉族患者群体HLA-A、B和DRB1低分辨分型结果,计算这3类白血病汉族患者群体的HLA-A、B和DRB1抗原频率,单体型频率和表型频率,联合应用中华骨髓库(CMDP)中健康汉族供者HLA表型频率数据,进一步推导出这3类白血病汉族患者群体找到至少1名HLA低分辨全相合供者概率及回归方程。结果ALL、AML、CML汉族患者群体表型种类数分别为416851、373903和464373种,其中31%的表型频率均>1/100万;ALL、AML、CML汉族患者群体在CMDP的汉族供者群体中找到至少1名HLA表型相同供者回归方程分别为:P=0.0824LgN-0.3667、P=0.0825LgN-0.3636和P=0.0829LgN-0.3644;计算出81.6%的ALL、81.9%的AML、82.4%的CML汉族患者要找到1名HLA低分辨表型相同的无关供者,CMDP中汉族有效供者群体数平均146.7万。结论应用不同类型白血病患者群体HLA-A、B和DRB1遗传学数据评估患者找到HLA相合供者概率较仅以健康供者群体HLA遗传学数据评估更为精确。为有效地提高患者的移植效果,需要征募更多的无关供者。Objective To analyze the probability of finding HLA-A, B, DRB1 matching unrelated donors for the patients with acute lymphoblastic leukemia （ ALL）, acute myeloid leukemia （AML） and chronic myeloid leukemia （CML）. Methods The frequencies of HLA-A, B, DRB1 antigens, baplotypes and phenotypes were estimated by Expectation Maximization based on the HLA types of 1201 ALL patients, 1065 AML patients and 1432 CML patients. These estimates were used to estimate the probability of finding at least a HLA-A, B, DRB1 matched unrelated donor for a patient with a phenotype in the healthy donor registry. Logarithmic curve fitting method was used to derive a regression equation to calculate P value. Results A total of 416 851 different HLA phenotypes in ALL patients, 373 903 different HLA phenotypes in AML patients, and 464 373 different HLA phenotypes in CML patients were detected, and among them 31% phenotypes were with the frequencies higher than one in a million. The formula of P = 0.082 4LgN - 0. 366 7, P = 0. 082 5 LgN - 0. 363 6 and P = 0. 082 9LgN -0. 364 4 were provided to estimate the probability of finding a HI.A-A, B, DRB1 matched unrelated Chinese donor for patients with ALL, AML and CML. ApproXimately 81.6% of ALL patients, 81.9% of AML patients and 82.4% of CML patients could find at least a HLA-A, B, and DRB1 matched donor in a pool of I 467 000 Chinese Han donors. Conclusion HLA genetics data from the patient group could be used to accurately estimate the probability of finding at least a HLA-A, B, DRB1 matched unrelated donor.

关 键 词：白血病 人类白细胞抗原 单体型 表型 无关供者 低分辨 全相合 匹配概率 汉族 

分 类 号：R457.11[医药卫生—治疗学] R733.7[医药卫生—临床医学]