HLA—Cw配型与异基因造血干细胞移植后GVHD关系的临床初探

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。

Primary Exploration of Relationship of HLA-Cw typing with graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

Objective To determine the effects of HLA-Cw typing on graft-versus-host disease and re-lapse 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. A-cute GVHD data were compared between the groups with different HLA-Cw typing results (matched and un-matched). 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 re-lapse. 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 statisti-cally significant difference in both Ⅰ～Ⅱ and Ⅲ acute GVHD between these two groups (P < 0. 05). Conclu-sion 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.