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目的探讨HLA-CW位点基因分型在造血干细胞移植(hematopoiceticstemcelltrans-plantation-HSCT)中的作用,对HLA-CW基因位点相合与不相合造血干细胞移植的效果进行分析。方法采用聚合酶链反应-序列特异性引物扩增(polymerasechainreaction-sequencespecificprimers,PCR-SSP)方法对HSCT供、受体共42个样本进行HLA-CW位点等位基因分析。结果HLA-CW基因全相合者9例造血重建,存活200d以上7例,1例存活303d复发,2例存活44d(死于感染),无病生存率(66.7±3.4)%。1例(11.1%)发生急性移植物抗宿主病(aGVHD),3例(33.3%)发生慢性移植物抗宿主病(cGVHD)。HLA-CW基因不相合者12例造血重建,存活200d以上6例,1例存活105d复发,6例存活75d死亡,无病生存率(41.7±5.4)%(P<0.05)。6例(50%)发生aGVHD;5例(41.7%)发生cGVHD(P>0.05)。结论HLA-CW基因不相合导致的aGVHD及相关死亡率明显高于CW基因相合者,显示CW基因不相合也是造成aGVHD发生率增高和影响移植效果的重要因素。
Objective To investigate the role of HLA-CW loci genotyping in hematopoietic stem cell transplantation-hematopoietic stem cell transplantation (HSCT), and to analyze the effect of HLA-CW loci on coincidence and incompatibility of hematopoietic stem cell transplantation. Methods HLA-CW locus allele analysis was performed on 42 HSCT donor and recipient samples by polymerase chain reaction-sequences specific primers (PCR-SSP). Results Nine cases of HLA-CW gene reconstructed with hematopoietic reconstitution survived for more than 200 days. One case survived for 303 days and the other survived for 44 days (died of infection). The disease-free survival rate was 66.7 ± 3.4%. One case (11.1%) developed acute graft versus host disease (aGVHD) and three (33.3%) developed chronic graft versus host disease (cGVHD). There were 12 cases of HLA-CW gene incompatible with hematopoietic reconstructions, 6 cases survived for more than 200 days, 1 case survived for 105 days and 6 cases survived for 75 days. The disease-free survival rate was 41.7 ± 5.4% (P <0.05). Six patients (50%) developed aGVHD and five patients (41.7%) developed cGVHD (P> 0.05). Conclusions The incidence of aGVHD and related mortality caused by the mismatch of HLA-CW gene is significantly higher than that of CW gene. It shows that the uncoordination of CW gene is also an important factor of increasing the incidence of aGVHD and affecting the transplantation effect.