儿童异基因造血干细胞移植后供者HLA识别巨细胞病毒抗原肽亲和力与患者巨细胞病毒感染的相关性

OBJECTIVE: To explore the correlation between the affinity while donor's HLA type recognizing different cytomegalovirus (CMV) antigen peptide and the occurrence of CMV infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. METHODS: To investigate the relationship between CMV reactivation, CMV infection or CMV related tissue/organ diseases and the different HLA-type recognition antigen peptide of the donors, we retrospectively analyzed the clinical data of 146 children with CMV infection for 6 months since from the time they underwent transplantation in Wuhan Children's Hospital. RESULTS: Among 146 patients, the HLA type of 82 (56.16％) cases had high affinity with PP65 alone, and 34 cases of CMV infection occurred after transplantation (41.46％). None of 5 cases that had a high affinity with IE-1 alone got CMV infection. None of 2 cases with no clear high-affinity peptide had CMV infection. Three of 5 cases that had a high affinity with PP65 and PP50 had CMV infection. Thirteen of 52 cases that had a high affinity with PP65 and IE-1 had CMV infection (25.00％). HLA with exclusive PP50 high affinity was not encountered. Donors with a high-affinity HLA locus associated with IE-1 showed a lower incidence of CMV infection after HSCT compared to those carrying only the PP65 high-affinity allele (22.81％ vs 41.46％, P＝0.029). CONCLUSION: HLA type with PP65 and IE-1 high-affinity covers approximately 99.8％ of the donors. Stem cells generated from HLA donors with high affinity with the CMV antigen peptide IE-1 can reduce the risk of post-transplantation CMV-activated infection in children.