CAJ | 학술논문

目的探讨供、受者白细胞介素10(IL-10)基因启动子区单核苷酸基因多态性(SNP)对恶性血液病患者HLA匹配同胞供者异基因造血干细胞移植(allo-HSCT)疗效的影响.方法采用序列特异性引物聚合酶链式反应检测77例供、受者IL-10基因1082 A/G、-819 T/C、-592 C/A位点的SNP,探讨供、受者不同基因型与受者移植疗效的相关性.结果 ATA/ATA纯合子型与非ATA/ATA纯合子受者各有33例和44例,两者Ⅱ～Ⅳ度急性移植物抗宿主病(aGVHD)的发生率分别为6.1％和25.0％(P＜0.05)；移植后预期5年移植相关死亡(TRM)率分别为(10.7±5.9)％和(29.7±5.2)％(P＜0.05);5年无病生存(DFS)率分别为(81.8±6.7)％和(56.8±7.5)％(P＜0.05).ATA/ATA纯合子型与非ATA/ATA纯合子受者间慢性移植物抗宿主病(cGVHD)发生率和复发率的差异无统计学意义(P＞0.05).供者为ATA/ATA纯合子和非ATA/ATA纯合子型者各有37例和40例,其相应受者Ⅱ～Ⅳ度aGVHD发生率、广泛型cGVHD发生率、5年累积复发率、TRM率、DFS率的差异均无统计学意义(P＞0.05).多因素分析显示,受者非ATA/ATA纯合子型和原发病为高危的受者为降低DFS的独立危险因素(危险度=2.911,P=0.029;危险度=2.686,P=0.027).结论在HLA相合同胞供者allo-HSCT中,与非IL-10 ATA/ATA基因型受者相比较,ATA/ATA基因型受者移植后Ⅱ～Ⅳ度aGVHD发生率和TRM率显著降低,其DFS率也较高.
목적 탐토공、수자백세포개소10(IL-10)기인계동자구단핵감산기인다태성(SNP)대악성혈액병환자HLA필배동포공자이기인조혈간세포이식(allo-HSCT)료효적영향.방법 채용서렬특이성인물취합매련식반응검측77례공、수자IL-10기인1082 A/G、-819 T/C、-592 C/A위점적SNP,탐토공、수자불동기인형여수자이식료효적상관성.결과 ATA/ATA순합자형여비ATA/ATA순합자수자각유33례화44례,량자Ⅱ～Ⅳ도급성이식물항숙주병(aGVHD)적발생솔분별위6.1％화25.0％(P＜0.05)；이식후예기5년이식상관사망(TRM)솔분별위(10.7±5.9)％화(29.7±5.2)％(P＜0.05);5년무병생존(DFS)솔분별위(81.8±6.7)％화(56.8±7.5)％(P＜0.05).ATA/ATA순합자형여비ATA/ATA순합자수자간만성이식물항숙주병(cGVHD)발생솔화복발솔적차이무통계학의의(P＞0.05).공자위ATA/ATA순합자화비ATA/ATA순합자형자각유37례화40례,기상응수자Ⅱ～Ⅳ도aGVHD발생솔、엄범형cGVHD발생솔、5년루적복발솔、TRM솔、DFS솔적차이균무통계학의의(P＞0.05).다인소분석현시,수자비ATA/ATA순합자형화원발병위고위적수자위강저DFS적독립위험인소(위험도=2.911,P=0.029;위험도=2.686,P=0.027).결론 재HLA상합동포공자allo-HSCT중,여비IL-10 ATA/ATA기인형수자상비교,ATA/ATA기인형수자이식후Ⅱ～Ⅳ도aGVHD발생솔화TRM솔현저강저,기DFS솔야교고.
Objective To explore the impact of IL-10 gene polymorphisms on the outcome in HLA matched sibling hematopoietic stem cell transplantation (HSCT).Methods PCR-sequencespecific primer (PCR-SSP) assay was used to analyze the SNP of IL-10 in 77 recipient and donor pairs:-1082 A/G,-819 T/C,-592 C/A.Results IL-10 ATA/ATA (1082,-819,-592) genotype in recipients significantly decreased the incidence of grade Ⅱ-Ⅳ acute graft vursus-host disease (aGVHD) (6.1％ vs.25.0 ％,P＜0.05),reduced 5-year transplant-related mortality (TRM) (10.7 ％± 5.9％ vs.29.7％ ± 5.2％,P＜0.05) and increased disease free survival (DFS) (81.8％ ± 6.7％ vs.56.8％ ± 7.5％,P＜0.05).With regard to the donor genotype,the incidence of grade Ⅱ-Ⅳ aGVHD,extensive chronic GVHD,5-year TRM and DFS had no signicant difference between IL-10 ATA/ATA and non ATA/ATA subgroup.Multivariable analysis also revealed that IL-10 non-ATA/ATA genotype in recipients and high-risk status of disease were two independent risk factors for DFS (HR =2.911,P =0.029; HR =2.686,P =0.027).Conclusion In HLA-matched sibling HSCT,the presence of recipient IL-10 ATA/ATA significantly decreased the incidence of grade Ⅱ-Ⅳ aGVHD and TRM,and increased DFS.