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Research of Human Leukocyte Antigen DR15 Gene Expression in Patients with Myelodysplastic Syndromes

Author: LiaoQiong
Tutor: LiXiao
School: Shanghai Jiaotong University
Course: Internal Medicine
Keywords: myelodysplastic syndromes PCR-SSP Human leukocyte antigen(HLA)
CLC: R551.3
Type: Master's thesis
Year: 2007
Downloads: 55
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Abstract


Purpose: To study the expression of human leukocyte antigen DR15(HLA-DR15) gene in patients with Myelodysplastic syndromes (MDS).Methods: HLA-DR15 was detected by the technique of polymerase chain reaction-sequence specific primers(PCR-SSP) in peripheral blood of MDS group(59 cases) and control group(104 cases).Results:①In the study group , the gene frequency of HLA-DR15(44.07%) was significantly higher than that in control group(12.5 %)(P <0.01). Relative risk was 5.52.②There were 16 patients with HLA-DR15 in groups of RA (34 cases). 4 of 6 cases with RAS were positive for HLA-DR15. In group of RAEB/RAEB-T patients, 4 of 12 had HLA-DR15 gene .While the ratio which expressed HLA-DR15 in CMML were 2/7. In comparison with normal control,the increased frequencies of HLA-DR15 were found in patients with MDS of RA and RAS subtypes with a strong statistical significance (p=0.000,0.003,respectively), but not in RAEB/RAEB-T and CMML subtypes (p=0.053, 0.229, respectively).③Defined by IPSS (International Prognostic Scoring System), the low risk group(IPSS≤1) had significantly higher frequency of HLA-DR15 than those with high risk group (IPSS≥1.5) (P <0.05); There was no difference in frequency of HLA-DR15 between cytogenetic abnormality and normality groups (p>0.05); The ratio of HLA-DR15 in patients with marrow myeloblast percentage(<5%) was higher than patients with marrow myeloblast percentage(≥5%),although the difference was not statistically sinificant(p=0.072).④A significant increase in the frequency of HLA-DR15 gene was found in patients with age less than 60 years (p=0.047). There was no difference in the ratio of HLA-R15 between male patients and female patients(P >0. 05).Conclusion: The results indicated that the expression frequency of HLA-DR15 gene was significant higher in MDS patients than in normal control. HLA-DR15 gene seems to contribute to the genetic susceptibility for patients with MDS (RR>1). The increased frequencies of HLA-DR15 were noted in patients with MDS of RA and RAS subtypes ; patients with the low risk group(IPSS≤1) and marrow myeloblast percentage(<5%) had higher incidences than high risk group (IPSS≥1.5) and marrow myeloblast percentage(≥5%).These suggested that HLA-DR15 gene might have association with bone marrow failure , but not with leukemia transformation. HLA-DR15 might to be a predict factor for prognosis of MDS. The frequency of HLA-DR15 gene was higher in patients with age less than 60 years. It was reported that younger age correlate significantly with a response to immunosuppressive treatment.These sugguested that HLA-DR15 might predict the probability of response to immunosupression in MDS. In conclusion, HLA-DR15 could be useful as a guide to pathophysiology, prognosis and treatment.

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CLC: > Medicine, health > Internal Medicine > Blood and lymphatic system diseases > Hematopoietic diseases > Bone marrow disease
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