单倍体造血干细胞移植模式下供者HLA-Bw4对移植后NK细胞重建及移植相关死亡风险的影响

目的:探讨在接受来自母体或旁系供者的非去T细胞单倍体造血干细胞移植时，供者HLA-Bw4表达对NK细胞重建和移植预后的影响。方法:本研究前瞻性入组了32例接受来自母体或旁系的供者非去T细胞单倍体移植患者（队列1），评估供者HLA-Bw4表达对NK细胞重建的影响；同时回顾性研究了278例接受来自母体或旁系的供者非去T细胞单倍体移植患者（队列2），分析供者HLA-Bw4对HSCT预后的影响。同时还分别比较了在接受移植后环磷酰胺（PT-Cy）和不接受PT-Cy的情况下，供者HLA-Bw4表达对HSCT预后影响的差异。结果:编码HLA-Bw4的供者促进了NK细胞的重建和功能恢复，PT-Cy体内应用并未...

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Published in中华血液学杂志 Vol. 45; no. 5; pp. 453 - 461
Main Authors 赵明, 徐郑丽, 余星星, 丁亦扬, 常英军, 张晓辉, 黄晓军, 赵翔宇
Format Journal Article
LanguageChinese
Published 北京大学人民医院、北京大学血液病研究所、国家血液系统疾病临床医学研究中心，北京市造血干细胞移植治疗血液病重点实验室，北京　100044%厦门大学第一附属医院血液科，厦门　361003 14.05.2024
Subjects
PT-Cy
移植相关死亡率
HLA-Bw4
NK reconstitution
Transplantation-related mortality
NK重建
移植后环磷酰胺
Online AccessGet full text
ISSN0253-2727
DOI10.3760/cma.j.cn.121090-20240314-00094

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Abstract 目的:探讨在接受来自母体或旁系供者的非去T细胞单倍体造血干细胞移植时，供者HLA-Bw4表达对NK细胞重建和移植预后的影响。方法:本研究前瞻性入组了32例接受来自母体或旁系的供者非去T细胞单倍体移植患者（队列1），评估供者HLA-Bw4表达对NK细胞重建的影响；同时回顾性研究了278例接受来自母体或旁系的供者非去T细胞单倍体移植患者（队列2），分析供者HLA-Bw4对HSCT预后的影响。同时还分别比较了在接受移植后环磷酰胺（PT-Cy）和不接受PT-Cy的情况下，供者HLA-Bw4表达对HSCT预后影响的差异。结果:编码HLA-Bw4的供者促进了NK细胞的重建和功能恢复，PT-Cy体内应用并未影响供者HLA-Bw4促进NK细胞重建。编码HLA-Bw4的供者与移植相关死亡率（Transplantation-related mortality，TRM），尤其是感染相关的TRM（infection-related TRM）降低相关，PT-Cy体内应用并未影响供者HLA-Bw4降低TRM。结论:在进行来自母体或旁系供者的非体外去T细胞单倍体移植时，编码HLA-Bw4的供者有助于快速NK细胞重建和功能恢复，并且与较低的TRM（尤其是感染相关TRM）显著相关。这些结果表明，供者HLA-Bw4的表达对于单倍体移植患者的临床结果具有重要意义。因此，在供受者选择和移植策略中，考虑供者HLA-Bw4可能具有临床意义。
AbstractList 目的:探讨在接受来自母体或旁系供者的非去T细胞单倍体造血干细胞移植时，供者HLA-Bw4表达对NK细胞重建和移植预后的影响。方法:本研究前瞻性入组了32例接受来自母体或旁系的供者非去T细胞单倍体移植患者（队列1），评估供者HLA-Bw4表达对NK细胞重建的影响；同时回顾性研究了278例接受来自母体或旁系的供者非去T细胞单倍体移植患者（队列2），分析供者HLA-Bw4对HSCT预后的影响。同时还分别比较了在接受移植后环磷酰胺（PT-Cy）和不接受PT-Cy的情况下，供者HLA-Bw4表达对HSCT预后影响的差异。结果:编码HLA-Bw4的供者促进了NK细胞的重建和功能恢复，PT-Cy体内应用并未影响供者HLA-Bw4促进NK细胞重建。编码HLA-Bw4的供者与移植相关死亡率（Transplantation-related mortality，TRM），尤其是感染相关的TRM（infection-related TRM）降低相关，PT-Cy体内应用并未影响供者HLA-Bw4降低TRM。结论:在进行来自母体或旁系供者的非体外去T细胞单倍体移植时，编码HLA-Bw4的供者有助于快速NK细胞重建和功能恢复，并且与较低的TRM（尤其是感染相关TRM）显著相关。这些结果表明，供者HLA-Bw4的表达对于单倍体移植患者的临床结果具有重要意义。因此，在供受者选择和移植策略中，考虑供者HLA-Bw4可能具有临床意义。
Abstract_FL Objective:To investigate the impact of donor human leukocyte antigen (HLA) -Bw4 expression on natural killer (NK) cell reconstitution and transplant outcomes in recipients undergoing haploidentical hematopoietic stem cell transplantation (HSCT) from maternal or related donors without ex vivo T-cell depletion.Methods:This study prospectively enrolled 32 patients who received T-replete haploidentical HSCT from maternal or collateral donors (cohort 1) to evaluate the facilitating effect of donor HLA-Bw4 expression on NK cell reconstitution. Furthermore, a retrospective analysis was conducted on 278 patients who underwent T-replete haploidentical HSCT from maternal or collateral donors (cohort 2) to analyze the impact of donor HLA-Bw4 expression on HSCT outcomes. Thus, a comparison was made between the effects of donor HLA-Bw4 expression on HSCT outcomes in patients receiving or not receiving post-transplant cyclophosphamide (PT-Cy) conditioning.Results:Donors expressing HLA-Bw4 alleles facilitated NK cell reconstitution and functional recovery, which remained unaffected by PT-Cy. Donors with HLA-Bw4 expression were associated with reduced transplant-related mortality (TRM), particularly mortality related to infections. The use of PT-Cy did not impact the ability of donor HLA-Bw4 to decrease TRM.Conclusion:In haploidentical HSCT from maternal or related donors without ex vivo T-cell depletion, the presence of donor HLA-Bw4 expression promotes rapid NK cell reconstitution and functional recovery and is significantly associated with lower TRM, especially infection-related mortality. These findings underscore the clinical significance of donor HLA-Bw4 expression in patients who underwent HSCT. Hence, the consideration of donor HLA-Bw4 in recipient selection and HSCT strategies holds important clinical implications.
Author 常英军
徐郑丽
张晓辉
赵明
丁亦扬
赵翔宇
黄晓军
余星星
AuthorAffiliation 北京大学人民医院、北京大学血液病研究所、国家血液系统疾病临床医学研究中心，北京市造血干细胞移植治疗血液病重点实验室，北京　100044%厦门大学第一附属医院血液科，厦门　361003
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Author_FL Ding Yiyang
Zhang Xiaohui
Yu Xingxing
Liu Kaiyan
Huang Xiaojun
Xu Zhengli
Zhao Ming
Chang Yingjun
Zhao Xiangyu
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Keywords PT-Cy
移植相关死亡率
HLA-Bw4
NK reconstitution
Transplantation-related mortality
NK重建
移植后环磷酰胺
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Title 单倍体造血干细胞移植模式下供者HLA-Bw4对移植后NK细胞重建及移植相关死亡风险的影响
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