中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2012年
12期
989-993
,共5页
蔡小矜%宋阿霞%王华%张平%张桂新%杨帆%魏嘉璘%马巧玲%阎嶂松%姜尔烈%黄勇%杨栋林%王玫%何祎%冯四洲%韩明哲
蔡小矜%宋阿霞%王華%張平%張桂新%楊帆%魏嘉璘%馬巧玲%閻嶂鬆%薑爾烈%黃勇%楊棟林%王玫%何祎%馮四洲%韓明哲
채소긍%송아하%왕화%장평%장계신%양범%위가린%마교령%염장송%강이렬%황용%양동림%왕매%하의%풍사주%한명철
干扰素γ%多态性,单核苷酸%造血干细胞移植%预后
榦擾素γ%多態性,單覈苷痠%造血榦細胞移植%預後
간우소γ%다태성,단핵감산%조혈간세포이식%예후
Interferon-gamma%Polymorphism,single nucleotide%Hematopoietic stem cell transplantation%Graft vs host disease%Prognosis
目的 研究供受者IFN-γ基因+874位点单核苷酸多态性(SNP)对恶性血液病患者HLA全相合同胞供者异基因造血干细胞移植(allo-HSCT)疗效的影响.方法 收集80例接受HLA全相合同胞供者allo-HSCT的恶性血液病患者移植前外周血单个核细胞标本,采用序列特异性引物PCR(PCR-SSP)方法检测供受者IFN-γ +874位点SNP,分析供受者不同基因型与移植疗效的相关性.结果 供者为IFN-γ +874 A/A与非A/A基因型的两组患者恢复中性粒细胞绝对计数(ANC)>0.5×109/L的中位时间分别为15(11~27)d和18(12~30)d,差异有统计学意义(P=0.029).供受者均为IFN-γ +874 A/A与+874A/A基因型的两组患者恢复ANC>0.5×109/L的中位时间分别为13(11~25) d和19(12~31)d,差异有统计学意义(P=0.019).受者为IFN-γ +874 A/A与非A/A基因型的两组患者各有11例(20.0%)和1例(4%)发生Ⅱ~Ⅳ度急性移植物抗宿主病(aGVHD)(P=0.041),24例(43.6%)和4例(16.0%)发生巨细胞病毒(CMV)血症(P=0.032),预期5年无事件生存(EFS)率分别为(58.2±6.7)%和(84.0±7.3)%(P=0.032),5年移植相关死亡(TRM)率分别为(33.7±6.8)%和(12.0±6.5)%(P=0.050),差异均有统计学意义.供受者均为IFN-γ +874 A/A与均为非A/A纯合子型的两组患者各有10例(21.7%)和2例(5.9%)发生Ⅱ~Ⅳ度aGVHD(P=0.050);21例(45.7%)和7例(20.6%)发生CMV血症(P=0.020),两组患者5年TRM率分别为(31.6±7.5)%和(13.6±6.5)%(P=0.048);5年EFS率分别为(56.8±7.3)%和(79.4±6.9)%(P=0.037),差异均有统计学意义.结论 在HLA全相合同胞供者allo-HSCT中,供者或供受者均为IFN-γ +874 A/A基因型的患者较非A/A基因型患者粒系植入时间显著提前,而受者或供受者均为A/A基因型较非A/A基因型患者移植后发生Ⅱ~Ⅳ度GVHD、CMV血症及TRM的风险显著增加,EFS率显著降低.
目的 研究供受者IFN-γ基因+874位點單覈苷痠多態性(SNP)對噁性血液病患者HLA全相閤同胞供者異基因造血榦細胞移植(allo-HSCT)療效的影響.方法 收集80例接受HLA全相閤同胞供者allo-HSCT的噁性血液病患者移植前外週血單箇覈細胞標本,採用序列特異性引物PCR(PCR-SSP)方法檢測供受者IFN-γ +874位點SNP,分析供受者不同基因型與移植療效的相關性.結果 供者為IFN-γ +874 A/A與非A/A基因型的兩組患者恢複中性粒細胞絕對計數(ANC)>0.5×109/L的中位時間分彆為15(11~27)d和18(12~30)d,差異有統計學意義(P=0.029).供受者均為IFN-γ +874 A/A與+874A/A基因型的兩組患者恢複ANC>0.5×109/L的中位時間分彆為13(11~25) d和19(12~31)d,差異有統計學意義(P=0.019).受者為IFN-γ +874 A/A與非A/A基因型的兩組患者各有11例(20.0%)和1例(4%)髮生Ⅱ~Ⅳ度急性移植物抗宿主病(aGVHD)(P=0.041),24例(43.6%)和4例(16.0%)髮生巨細胞病毒(CMV)血癥(P=0.032),預期5年無事件生存(EFS)率分彆為(58.2±6.7)%和(84.0±7.3)%(P=0.032),5年移植相關死亡(TRM)率分彆為(33.7±6.8)%和(12.0±6.5)%(P=0.050),差異均有統計學意義.供受者均為IFN-γ +874 A/A與均為非A/A純閤子型的兩組患者各有10例(21.7%)和2例(5.9%)髮生Ⅱ~Ⅳ度aGVHD(P=0.050);21例(45.7%)和7例(20.6%)髮生CMV血癥(P=0.020),兩組患者5年TRM率分彆為(31.6±7.5)%和(13.6±6.5)%(P=0.048);5年EFS率分彆為(56.8±7.3)%和(79.4±6.9)%(P=0.037),差異均有統計學意義.結論 在HLA全相閤同胞供者allo-HSCT中,供者或供受者均為IFN-γ +874 A/A基因型的患者較非A/A基因型患者粒繫植入時間顯著提前,而受者或供受者均為A/A基因型較非A/A基因型患者移植後髮生Ⅱ~Ⅳ度GVHD、CMV血癥及TRM的風險顯著增加,EFS率顯著降低.
목적 연구공수자IFN-γ기인+874위점단핵감산다태성(SNP)대악성혈액병환자HLA전상합동포공자이기인조혈간세포이식(allo-HSCT)료효적영향.방법 수집80례접수HLA전상합동포공자allo-HSCT적악성혈액병환자이식전외주혈단개핵세포표본,채용서렬특이성인물PCR(PCR-SSP)방법검측공수자IFN-γ +874위점SNP,분석공수자불동기인형여이식료효적상관성.결과 공자위IFN-γ +874 A/A여비A/A기인형적량조환자회복중성립세포절대계수(ANC)>0.5×109/L적중위시간분별위15(11~27)d화18(12~30)d,차이유통계학의의(P=0.029).공수자균위IFN-γ +874 A/A여+874A/A기인형적량조환자회복ANC>0.5×109/L적중위시간분별위13(11~25) d화19(12~31)d,차이유통계학의의(P=0.019).수자위IFN-γ +874 A/A여비A/A기인형적량조환자각유11례(20.0%)화1례(4%)발생Ⅱ~Ⅳ도급성이식물항숙주병(aGVHD)(P=0.041),24례(43.6%)화4례(16.0%)발생거세포병독(CMV)혈증(P=0.032),예기5년무사건생존(EFS)솔분별위(58.2±6.7)%화(84.0±7.3)%(P=0.032),5년이식상관사망(TRM)솔분별위(33.7±6.8)%화(12.0±6.5)%(P=0.050),차이균유통계학의의.공수자균위IFN-γ +874 A/A여균위비A/A순합자형적량조환자각유10례(21.7%)화2례(5.9%)발생Ⅱ~Ⅳ도aGVHD(P=0.050);21례(45.7%)화7례(20.6%)발생CMV혈증(P=0.020),량조환자5년TRM솔분별위(31.6±7.5)%화(13.6±6.5)%(P=0.048);5년EFS솔분별위(56.8±7.3)%화(79.4±6.9)%(P=0.037),차이균유통계학의의.결론 재HLA전상합동포공자allo-HSCT중,공자혹공수자균위IFN-γ +874 A/A기인형적환자교비A/A기인형환자립계식입시간현저제전,이수자혹공수자균위A/A기인형교비A/A기인형환자이식후발생Ⅱ~Ⅳ도GVHD、CMV혈증급TRM적풍험현저증가,EFS솔현저강저.
Objective To explore the impact of IFN-γ+874 polymorphisms on the outcome in HLA matched sibling HSCT. Methods We used PCR-sequence-specific primer analysis (PCR-SSP) to analyze the polymorphisms of IFN-γ +874 T/A in 80 recipient and donor pairs from October 2005 to March 2008. Results Recipients having donors who possessed IFN-γ +874 A/A genotype had significantly earlier neutrophil recovery compared with those having donors with non-A/A genotype (15(11-27) days vs 18(12-30) days, P=0.029). And IFN-γ +874 A/A in both recipients and donors further facilitated neutrophil recovery compared with others (13(11-25) days and 19(12-31) days, P=0.019). Besides, IFN-γ +874 A/A in recipients increased the probablity of grade Ⅱ-Ⅳ acute graft vursus disease (aGVHD) and cytomegalo-virus viraemia compared with IFN-γ +874 T/A or T/T genotype (20% vs 4% P=0.041, 43.6% vs 16.0% P=0.032), which lead to increased 5-year transplant-related mortality (TRM) (33.7%±6.8% vs 12.0%±6.5%, P=0.050) and decreased 5-year event free survival (EFS) [(58.2±6.7)% vs (84.0±7.3)%, P=0.032] compared with the latter. IFN-γ+874 A/A in both recipients and donors also significantly increased the probablity of grade Ⅱ-Ⅳ aGVHD and cytomegalovirus viraemia compared with the other (21.7% vs 5.9%, P=0.050; 45.7% vs 20.6%, P=0.020), which caused increased 5-year TRM [(31.6±7.5)% vs (13.6±6.5)%, P=0.048] and decreased 5-year EFS [(56.8±7.3)% vs (79.4±6.9)%, P=0.037] compared with the other. Conclusion In HLA-matched sibling HSCT setting, the presences of IFN-γ+874 T allele in recipients or in both recipients and donors significantly decreased the risk of grade Ⅱ-Ⅳ aGVHD and CMV infection and increased EFS. While IFN-γ+874 A/A in donors or in both recipients and donors was associated with shorter duration to neutrophil recovery.
