Author/Editor		Rožman, Primož
Title		Vpliv trombocitnih aloantigenov HPA na presaditev alogenskega kostnega mozga
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2001
Volume		str. 66
Language		slo
Abstract		Bone marrow transplantation (BMT) is the best therapy in certain haematological diseases. The success of BMT depends on the degree of HLA-mediated histocompatibility between the donor and recipient. Despite a complete HLA matching of donors and patients, the graft-versus-host disease (GVHD) still emerges in around 25% of BMT cases. This phenomenon has been attributed to the disparity of minor histocompatibility antigens (mHA). In our investigation, platelet antigens HPA-1, -2, -3, -4 and -5 were considered potential minor histocompatibility antigens. After transfusions of blood and during pregnancies, HPA alloantigens can induce the production of platelet-specific antibodies. This fact, as well as their wide tissue distribution, allows the hypothesis that the HPA antigens play a role of minor histocompatibility antigens in BMT. The outcomes of the BMT were retrospectively analysed in a cohort of 174 patients who have received a transplant from HLA identical siblings. Donor/recipient pairs were genotyped for HPA alleles before transplantation and then grouped into two groups. The first group received HPA-matched and the second received HPA-mismatched grafts. Using a corresponding epidemiological method, the clinical outcomes of both groups were then evaluated and the success rate in both groups determined statistically. The results show that the mismatches of HPA -1, -2, -3, -4 and -5 antigens did not affect the dynamics of the bone marrow homing and of haematopoietic recovery. In patients younger than 16 years, HPA-5 mismatches increased the incidence of GVHD (p=0,019), the HPA-1 mismatches in older patients decreased the probability of GVHD (p=0,042); both outcomes, however, did not affect the overall survival. While there has been no cumulative effect of HPA mismatches on the incidence of GVHD, it was significantly higher in older patients (p<0.001). (Abstract truncated at 2000 characters).
Descriptors		BONE MARROW TRANSPLANTATION HISTOCOMPATIBILITY TESTING ANTIGENS, HUMAN PLATELET TRANSPLANTATION, HOMOLOGOUS MINOR HISTOCOMPATIBILITY ANTIGENS ALLELES GRAFT VS HOST DISEASE