徐世侠, 张在文, 冯博, 等. HLA-DPB1位点相合情况对非血缘供者造血干细胞移植结局的影响[J]. 器官移植, 2017, 8(4): 282-288. DOI: 10.3969/j.issn.1674-7445.2017.04.006
引用本文: 徐世侠, 张在文, 冯博, 等. HLA-DPB1位点相合情况对非血缘供者造血干细胞移植结局的影响[J]. 器官移植, 2017, 8(4): 282-288. DOI: 10.3969/j.issn.1674-7445.2017.04.006
Xu Shixia, Zhang Zaiwen, Feng Bo, et al. Effect of HLA-DPB1 locus match on clinical outcomes of unrelated donor hematopoietic stem cell transplantation: a Meta-analysis[J]. ORGAN TRANSPLANTATION, 2017, 8(4): 282-288. DOI: 10.3969/j.issn.1674-7445.2017.04.006
Citation: Xu Shixia, Zhang Zaiwen, Feng Bo, et al. Effect of HLA-DPB1 locus match on clinical outcomes of unrelated donor hematopoietic stem cell transplantation: a Meta-analysis[J]. ORGAN TRANSPLANTATION, 2017, 8(4): 282-288. DOI: 10.3969/j.issn.1674-7445.2017.04.006

HLA-DPB1位点相合情况对非血缘供者造血干细胞移植结局的影响

Effect of HLA-DPB1 locus match on clinical outcomes of unrelated donor hematopoietic stem cell transplantation: a Meta-analysis

  • 摘要:
      目的  系统评价HLA-DPB1位点不相合对非血缘供者造血干细胞移植结局的影响。
      方法  检索1995年1月至2016年12月PubMed数据库、Embase数据库、国际骨髓移植中心登记处数据库(CIBMTR)、考克兰临床对照中心登记处数据库、考克兰相关文献资料数据库、中国生物医学文献数据库(CBM)、中国知网(CNKI)数据库等国内外数据库, 收集关于HLA-DPB1位点不相合对非血缘供者造血干细胞移植临床结局影响的国内外文献。采用Review Manager 5.3软件分析存活率, 植入失败发生率、移植物抗宿主病(GVHD)发生率、复发率及移植相关病死率等不良事件发生率, 并做漏斗图评估发表偏倚。
      结果  纳入19篇文献, 共26 634例患者。Meta分析结果表明, 与HLA-DPB1相合组比较, HLA-DPB1不相合组受者的无病存活率较低、在非T细胞去除的移植中受者的总存活率降低, HLA-DPB1不相合组受者重症GVHD的发生率及移植相关病死率较高, 且2个位点不相合较1个位点不相合受者移植相关病死率更高。
      结论  HLA-DPB1位点对非血缘供者造血干细胞移植的存活率及不良事件发生率具有明显的影响, 在选择非血缘供者时应考虑到HLA-DPB1位点的相合情况。

     

    Abstract:
      Objective  To systematically evaluate the effect of HLA-DPB1 mismatch on the clinical outcomes of unrelated donor hematopoietic stem cell transplantation.
      Methods  Relevant studies analyzing the effect of HLA-DPB1 mismatch upon the clinical outcomes of unrelated donor hematopoietic stem cell transplantation published from January 1995 to December 2016 were retrieved from the PubMed, Embase, Center of International Bone Marrow Transplant Registration, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Chinese BioMedical Literature Database and China National Knowledge Infrastructure database. The survival rate, the incidence of implantation failure, graft-versus-host disease (GVHD), recurrence rate, transplantation-related mortality rate and other adverse events were analyzed by Review Manager 5.3 software. Funnel plot was utilized to assess the publication bias.
      Results  A total of 19 literatures consisting of 26 634 patients were retrieved. Meta-analysis demonstrated that compared with the recipients in the HLA-DPB1 match group, those in the HLA-DPB1 mismatch group had lower disease-free survival rate and overall survival rate in non-T cell-depleted transplantation. In the HLA-DPB1 mismatch group, the incidence of severe GVHD and transplantation-related mortality(TRM) rate were higher. And the TRM rate of two loci mismatch was more evident than that of one locus mismatch.
      Conclusions  HLA-DPB1 locus exerts significant effect on the survival rate and incidence of adverse events after unrelated donor hematopoietic stem cell transplantation. The status of HLA-DPB1 match should be considered when selecting the unrelated donors.

     

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