Blood: HLA-B pilot genotype predicts hlA mismatch with prognosis of bloodless donor HCT
Last Update: 2020-06-16
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Hematopoietic cell transplantation (HCT) from hlA mismatched non-blood-related donors can cure life-threatening blood diseases, but its success rate is limited by graft-resistant host disease (GVHD)The HLA-B pilot gene encodes methionine (M) or sucone (T) in position 2 to produce TT, MT, or MM genotypeThe dit-state HLA-B pilot gene predicts the GVHD risk of HLA-B-mismatched HCTIf the pilot gene also affects the prognosis of other HLA-mismatched transplants, the treatment strategy can be improved in the future to greatly improve the patient's prognosisPetersdorf et alidentified the pilot genotype of 11,872 patients transplanted from HLA-A,-B, -C, -DRB1 or -DQB1 non-blood donors between 1988 and 2016Using the multivariate regression method, the risk factors associated with the patient's pilot genotype were assessed according to the HLA gene base mismatch, and the risks associated with HLA-A, A,-B, -C, -DRB1 or -DQB1 were assessed based on the patient's pilot genotypeThe effectof patient's pilot genotype on acute GVHD and mortality varies depending on the HLA gene baseCompared to HLA-DQB1 mismatched TT patients, THE non-recurrence mortality rate of MM patients with HLA-DQB1 mismatches is higher (risk ratio is 1.35, p-0.01)HLA-DRB1 mismatched MM or MT patients with a higher risk of III-IV GVHD (advantage ratio 2.52 and 1.51, respectively) compared to HLA-DRB1 mismatched TT patientsPatients are more resistant to HLA-DQB1 unit mismatches than other site mismatchesThe pre-prognosis after HLA-mismatched transplantdepends on the distates of the HLA-B pilot and the HLA gene base mismatchIn summary, the limitation of the patient's pilot gene variant for HLA mismatch escticile improves new informationOr you can wisely select mismatched donors based on the patient's lead gene to increase the success rate of HLA mismatched non-blood transplants
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