Analyse the risk factors for producing anti-HLA antibodies in patients with hematological diseases
Objective To explore the risk factors for the production of anti-HLA antibodies in patients with hematologi-cal diseases before hematopoietic stemcell transplantation.Methods The results and clinical data of 1 008 patients with he-matological diseases in our hospital who underwent anti-HLA antibody testing were collected by using Luminex technology platform before transplantation from 2016 to 2018 for statistical analysis.Results The total positive rate of anti-HLA anti-bodies in 1 008 patients was 24.08％.Multivariate analysis showed that independent risk factors associated with the produc-tion of anti-HLA antibodies included age≥ 30 years old(P=0.046,OR1.467,95％CI1.007-2.136),time from disease diag-nosis to antibody testing≥41 days(P=0.000,OR1.830,95％ CI 1.306-2.565),initial platelet count＜20×109/L(P=0.020,OR1.543,95％ CI 1.072-2.220),prior pregnancy(P=0.000,OR5.187,95％CI3.689-7.293),transfusions before admission(P=0.001,OR1.762,95％ CI 1.257-2.470)and total platelet transfusion volumes after admission≥30 U(P=0.000,OR 2.352,95％ CI 1.638-3.376).Age ≥30 years old(P=0.023,OR=1.839,95％ CI 1.088-3.108)and prior pregnancy(P=0.042,OR=5.258,95％ CI 1.062-26.038)are associated with the production of anti-HLA class Ⅰ and class Ⅱ antibodies,respectively.The time from disease diagnosis to antibody testing≥41 days(P=0.000,OR=2.873,95％ CI 1.612-5.119),in-itial platelet count＜20×109/L(P=0.008,OR=2.164,95％ CI 1.225-3.822),prior pregnancy(P=0.002,OR=6.734,95％ CI 1.993-22.751),transfusions before admission(P=0.001,OR=2.746,95％ CI 1.531-4.925)and total platelet transfusion volumes after admission＞30 U(P=0.006,OR=3.459,95％ CI 1.416-8.451)are associated with the production of anti-HLA class Ⅰ and Ⅱ antibodies.Conclusion Older age,longer course of disease,lower PLT count,history of pregnancy and blood transfusion,and higher total amount of PLT transfusion are risk factors which affect the production of anti-HLA anti-bodies.Therefore,it is advisable to test for anti-HLA antibodies according to the situation before transplantation,which is of great value in guiding donor selection,monitoring antibody changes and improving transplant prognosis.
human leucocyte antigen(HLA)anti-HLA antibodyhematopoietic stem cell transplantationhematolo-gytransfusion
万方数据
维普
