目的:中枢神经系统(CNS)累及侵袭性B细胞淋巴瘤,作为全身性疾病的原发性或继发性事件,预示着预后不良。这项研究旨在通过分析人类白细胞抗原(HLA)基因型来确定中枢神经系统复发高危患者。
方法:我们回顾性检查了164例系统性淋巴瘤患者的HLA基因型,原发性中枢神经系统淋巴瘤,和全身淋巴瘤的中枢神经系统复发。分析患者记录,和HLA分型由芬兰红十字会血液服务进行。排除接受中枢神经系统预防的患者后,131名患者被纳入最终分析。
结果:发现HLA-A*31基因型与中枢神经系统疾病之间有很强的关联(p=0.001)。此外,各种HLA基因型与乳酸脱氢酶水平相关,结外疾病,国际预后指数评分,疾病阶段。
结论:患者的遗传构成,而不仅仅是疾病相关因素,在中枢神经系统淋巴瘤的嗜性中起作用。如果在更大的研究中得到证实,确定淋巴瘤患者的HLA基因型可以为预测CNS复发提供有价值的信息.
OBJECTIVE: Central nervous system (CNS) involvement in aggressive B-cell lymphoma, either as a primary or secondary event to systemic disease, portends a poor prognosis. This study sought to identify patients at high risk for CNS relapse by analyzing their human leukocyte antigen (HLA) genotypes.
METHODS: We retrospectively examined the HLA genotypes of 164 patients with systemic lymphoma, primary CNS lymphoma, and CNS relapse of systemic lymphoma. Patient records were analyzed, and HLA typing was performed by the Finnish Red Cross Blood Service. After excluding patients who received CNS prophylaxis, 131 patients were included in the final analysis.
RESULTS: A strong association was found between the HLA-A*31 genotype and CNS disease (p=0.001). Additionally, various HLA genotypes were linked to lactate dehydrogenase levels, extranodal disease, International Prognostic Index score, and disease stage.
CONCLUSIONS: The patient\'s genetic constitution, rather than solely disease-related factors, plays a role in the tropism of lymphoma for the CNS. If confirmed in a larger study, defining the HLA genotype of a lymphoma patient could provide valuable information for predicting CNS relapse.