摘要目的 对白血病患者与非亲缘造血干细胞供者进行HLA-Cw基因高分辨分型,探讨供、受者的相合几率.方法 用序列特异性引物聚合酶链反应(PCR-SSP)联合序列特异性寡核苷酸探针(PCR-SSOP)方法进行HLA高分辨分型,依据分型结果将78例白血病患者与来自中国造血干细胞捐献者资料库中的126名供者进行配对,选择配合最佳者.结果 21例急性淋巴细胞白血病(ALL)患者中,HLA-Cw高分辨分型的常见基因型为Cw*0102、Cw*0304、Cw*0302、Cw*0702和Cw*0801,其表型频率分别为0.57、0.33、0.19、0.14和0.14;ALL患者的Cw*0102和Cw*0304的表型频率明显高于捐献者(P＜0.05);7例患者(33.3%,7/21)的10个等位基因与捐献者全相合,HLA-Cw全相合常见的基因亚位点依次为Cw*0102(4/7)、Cw*0702(2/7).34例慢性粒细胞白血病(CML)患者中,HLA-Cw高分辨分型的常见基因型为Cw*0702、Cw*0102、Cw*0304、Cw*0801、Cw*0401和Cw*0303,其表型频率分别为0.44、0.38、0.21、0.18、0.15和0.12;与捐献者相比,CML患者各基因型的表型频率的差异均无统计学意义;8例患者(23.5%,8/34)的10个等位基因与捐献者全相合,HLA-Cw全相合常见的基因亚位点依次为Cw*0702(5/8)、Cw*0304(3/8).23例急性髓系白血病(AML)患者中,4例的10个等位基因与捐献者全相合,其原发病均为AML-M2型.结论 ALL患者和捐献者的Cw*0102和Cw*0304基因表型频率较高,有利ALL患者寻找到HLA-Cw相合的供者.

abstractsObjective To study high resolution typing of HLA-Cw and its effect on unrelated blood stem cell transplantation(BMT)in acute leukemia.Methods High resolution HLA-Cw analysis was performed on 78 patients(21 cases of ALL,34 cases of CML,23 cases of AML)from the data base of China Marrow Donor Program by using PCR-SSP and PCR-SSOP.Results In ALL patients,the HLA-Cw with common gene site was Cw*0102,Cw*0304,Cw*0302,Cw*0702,Cw*0801,and the phenotype frequencies were 0.57,0.33,0.19,0.14 and 0.14 respectively.The differences between these phenotype frequencies of Cw*0102 and Cw*0304 were statistically significant in ALL and donors(P＜0.05).Seven ALL patients(7/21)and donors were matched with loci in HLA-A,B,Cw,DRB1,DQB1,among which Cw*0102 was the subsites with highest frequency,followed by Cw*0702.In CML patients,the HLA-Cw with common gene site was Cw*0702,Cw*0102,Cw*0304,Cw*0801,Cw*0401,Cw*0303,and the phenotype frequencies were 0.44,0.38,0.21,0.18,0.15,0.12 respectively,with the differences between these phenotype frequencies being not statistically significant(P＞0.05).Eight CML patients(8/32)and donors were matched with loci in HLA-A,B,Cw,DR and DQ,among which Cw*0702 was the subsites with highest frequency,followed bv Cw*0304.All of the 4 M2 patients and donors were matched with loci in 23 cases of AML.Conclusion Cw*0102 and Cw*0304 have the obviously highest phenotype frequencies in ALL,which is beneficial for the selection of HLA-Cw matched donors.