Major Histocompatibility Complex 2018; 25 (1): 56 82 抄録集 16 2018 3 3 7 2 4 43 TEL 06 6962 7001 594 1101 840 TEL 0725 56 1220 56
16 MHC 2018; 25 (1) 参加費 1 2,000 2 1,000 3 3,000 会議等 1 3 3 13:00 13:10 2 3 312:00 13:00 3 3 3 17:20 会場地図 7 2 4 43 TEL 06 6962 7001 JR 350 m 57
MHC 2018; 25 (1) 16 プログラム 8 30 10 00 HLA 10 25 10 30 10 30 11 00 開会の挨拶 オープニングセミナー 17 HLA 43 HLA 11 00 12 00 一般演題 (1) 1 HLA 1) 2) 1) 1) 1) 1) 1) 1) 1) 1) 2) 2 C3d de novo HLA class II dndsa epitope 3 HLA 1) 2) 1) 1) 1) 2) 1) 1) 2) 4 denovodsa HLAeplet 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 2) 1) 2) 12 00 13 00 昼食 世話人会 58
16 MHC 2018; 25 (1) 13 00 13 10 総会 13 10 14 10 一般演題 (2) HLA 5 HLA 1) 1) 1) 1) 2) 1) 1) 2) 6NGS HLA HLA 7 SSOP HLA HLA 1) 2) 1) 1) 1) 2) 1) 1) 2) 8 GVHD 1) 1) 2) 1) 1) 1) 1) 1) 1) 1) 1) 1) 2) 14 10 15 40 シンポジウム (1) HLA 1 HLA 2 HLA HLA 3 HLA 15 40 15 50 休憩 59
MHC 2018; 25 (1) 16 15 50 17 20 シンポジウム (2) 1 2 HLA 3 17 20 意見交換会 15 30 60
16 MHC 2018; 25 (1) 10:30 11:00 オープニングセミナー 17 HLA 43 HLA 61
MHC 2018; 25 (1) 16 17 HLA 43 HLA 2017 9 17 HLA IHIW, International HLA and Immunogenetics Workshop 43 ASHI, American Society for Histocompatibility and Immunogenetics 1 2017 7 Jon van Rood Jon van Rood Rose Payne HLA NIMA Non Inherited Maternal Antigen 3 HLA NGS A*24:02:01:01 A*24:02:01:02L A*01:01:01:01 HLA-Aw1-1-1-1-1-1- 1-1-1-1-1-1-1-1-1-1-1 - HLA 5 UTR, exon1, intron1 5 7 2 2 NGS Next Generation Sequencing IHIW 29 24 DNA NGS I 1 2% II 2 5% PCR NGS XML HTML 4 HLA IHIW / eplet Leiden triplet PIRCHE II CD4+T ASHI American Society of Transplantation AST STAR Sensitization in Transplantation: Assessment of Risk A B C DRB1 DRB3 DRB4 DRB5 DQA1 DQB1 DPA1 DPB1 99.3% 98.2% 99.2% 96.8% 97.6% 95.6% 96.7% 99.4% 97.6% 98.4% 96.8% 0.7% 1.8% 0.8% 3.2% 2.4% 5.4% 3.3% 0.6% 2.4% 1.6% 3.2% 62
16 MHC 2018; 25 (1) 5 HLA IHIW 1996 HLA 19 46,216 HLA 30,212 1 I II DQB1 C GVHD 63
MHC 2018; 25 (1) 16 11:00 12:00 一般演題 (1) 演題番号 1 ~ 4 64
16 MHC 2018; 25 (1) 1 HLA 1) 2) 1) 1) 1) 1) 1) 1) 1) 1) 2) Antibody mediated rejection AMR HLA donor specific HLA antibody: DSA AMR 2014 HLA de novo DSA dndsa AMR 2014 1 HLA identical 120 1, 3, 5 Cr HLA dndsa AMR 101 84.2% HLA 16/101 15.8% dndsa dndsa 1 2.6% 3 8.0% 5 14.2% dndsa Cr 1.47 0.93 2.74 mg/dl 395 62 2998 mg/gcr class I 3 class II DR/DQ 3/10 13 6 46.2% chronic active AMR CAAMR CAAMR 1 dn DSA 15.8% AMR 65
MHC 2018; 25 (1) 16 2 C3d de novo HLA class II dndsa epitope HLA class II dndsa 10 40% Luminex single antigen beads SAB DSA DSA DSA 5 AMR DSA epitope Continuous epitope Discontinuous epitope 2000 2 2017 3 HLA class II DSA 115 26 AMR N=14 N=12 HLA Luminex SAB Immucore HLA Epitope Registry dndsa 26 DR 10 DQ 6 DR+DQ 10 1 AMR 14 DSA C3d DSA C3d DSA 2 DSA C3d R 2 =0.588 epitope epitope R 2 =0.546 R 2 =0.808 epitope DSA C3d 3 HLA-DRB1 -DRB3/4/5 -DQA1/B1 DSA C3d epitope HLA-DQA1/B1 epitope DSA C3d epitope P=0.0390 P=0.0005 4 epitope AMR HLA-DQA1/B1 DSA No AMR 4 DSA epitope AMR 16 DSA 14 epitope P=0.0093 HLA-class II dndsa HLA-DQA1/B1 epitope DSA AMR 66
16 MHC 2018; 25 (1) 3 HLA 1) 2) 1) 1) 1) 2) 1) 1) 2) HLA HLA HLA HLA 32.1% 34/106 7.2% 16/222 HLA HLA 2015 DSA HLA IgG 2009 1 2017 5 2 DSA 3 2 DSA 3 /85 3.5% 9 B to A B IgM2 IgG 1 DSA HLA- A24 MFI=3,996 B44 MFI=7,523 DR8 MFI=16,274 DQ6 MFI=22,737 Rituximab 4 IVIG B IgM 16 IgG 1 HLA 3 11 HLA 1 Class I 6 HLA HLA-DQ6 10 DSA HLA-DR4 MFI=11,745 HLA-DR4 3 IVIG HLA 3 38 HLA-DR4 MFI=11,425 HLA-A11 MFI=2,528 B54 MFI=3,608 3 DSA 6 HLA 1 10 DSA HLA-DR8 MFI=3,014 DQ6 MFI=1,829 HLA 7 DSA DSA DQ4 MFI=1,440 50 DSA DQ6 MFI=17,896 DQ4 MFI=20,050 DSA 67
MHC 2018; 25 (1) 16 4 denovodsa HLAeplet 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 2) 1) 2) AMR HLA DSA HLA 3 eplet DSA AMR denovodsa HLAeplet HLA HLA-A, B, DR, DQ 8locus 67 44.6 41 DSA denovodsa MM eplet eplet HLA Matchmaker denovo DSA 15 4 CLAD DSA ABDR 6locus MM HLA DSA 4.40 vs 4.14 p=0.46 ABDR MM eplet 29.13 vs 24.65 p=0.15 DQ MM HLA 1.40 vs 0.98 p=0.045 MM eplet 12.20 vs 8.93 p=0.075 DSA DQ EpletMM 4 48 DSA 86.7% 84.2% 70.0% 56.6% logrank p=0.0445 denovo DSA HLAeplet DQ locus denovod- SA 68
16 MHC 2018; 25 (1) 12:00 13:00 昼食 世話人会 13:30 13:40 総会 69
MHC 2018; 25 (1) 16 13:10 14:10 一般演題 (2) HLA 演題番号 5 ~ 8 70
16 MHC 2018; 25 (1) 5 HLA 1) 1) 1) 1) 2) 1) 1) 2) HLA 2011 1 2017 12 61 HLA WAKFlow MicroSSP HLA-A B C DRB1 DQB1 HLA 2017 FlowPRA Screening LAB- Screen Single Antigen DNA 576 HLA 0.01% 30 5.2% HLA A34 A68 A74 B18 B41 B53 B63 B77 B77 FlowPRA Screening DNA A*24:07 A*24:10 B*07:05 B*15:25 B*15:35 B*35:05 C*12:05 DRB1*14:07 DRB1*15:04 LABScreen Single Antigen WAKFlow MicroSSP 71
MHC 2018; 25 (1) 16 6NGS HLA HLA HLA Luminex 2 DQ DP NGS HLA DQ DP NGS HLA 2,909 Scisco Genetics Short Range NGS HLA Class I exon1 7 HLA Class II exon1 4 HLA DPA1 exon2 4 Miseq Illumina HLA 26 5 A 3 B 1 C 3 DRB1 1 DRB3 2 DRB4 1DRB5 1 DQB1 5 DQA1 1 DPB1 4 DPA1 3 HLA-A, B, C, DRB1 NGS HLA DQA1 DQB1 DPA1 DPB1 72
16 MHC 2018; 25 (1) 7 SSOP HLA HLA 1) 2) 1) 1) 1) 2) 1) 1) 2) HLA homo to hetero GVHD HLA 1 2 homo GVHD HLA SSOP DNA GVHD DNA SSOP HLA WAKUFlow HLA GVHD 1 3 4 26 37 HLA 1 2 HLA-A(2,24), -B(7,48), -Cw(7,8), -DR(1,4), -DQ(5,8) HLA-A(24,26), -B(7,51), -Cw(7,14), -DR(1,14), -DQ(5,5) B to O MMF 15 19 basiliximab IL2R 24 28 GVHD 98 GVHD 100 35 HLA MFI 53 5,252 629 1 3 RCC-LR 2 1 FFP- LR240 1 25 Gy HLA GVHD homo to hetero GVHD 73
MHC 2018; 25 (1) 16 8 GVHD 1) 1) 2) 1) 1) 1) 1) 1) 1) 1) 1) 1) 2) 59 10 13 FISH 14.3% 17.8% Graft-versus- Host Disease: GVHD G-CSF GVHD Thrombotic Microangiopathy: TMA FISH 5% POD37 35% POD57 62% POD74 POD62 >95% T 90 95% Anti-Thymocyte Globulin: ATG AST/ALT GVHD POD117 HLA Locus A B C DR Donor 02:06/31:01 39:01/46:01 01:02/07:02 08:03/15:01 Recipient 02:01/24:02 40:01/51:01 03:04/15:02 14:54/15:01 HLA GVHD HLA GVHD T GVHD 74
16 MHC 2018; 25 (1) 14:10 15:40 シンポジウム (1) HLA 1 HLA 2 HLA HLA 3 HLA 75
MHC 2018; 25 (1) 16 1 HLA ahsct ahsct HLA human leukocyte antigen HLA-matched related donor, MRD HLA HLA ahsct 2 HLA HLA-matched unrelated donor, MUD HLA ahsct HLA GVHD graft-versus-host disease HLA HLA HLA Science 2002 Ruggeri KIR Killer Cell Immunoglobulin-like Receptor GVH 20 0% ahsct ATG MMF NK NK NIMA noninherited maternal antigens HLA GVHD grade II-IV GVHD 30% GVHD HLA T CD34 ex vivo purging T T anti- T cell globulin, ATG posttransplant cyclophosphamide, PTCy in vivo purging day 3 4 CY T T GVHD HLA GVHD PTCy HLA PTCy GVHD ATG HLA GVHD GVHD GVL graft-versus-leukemia ATG HLA 2.5 mg/kg ATG GVHD HLA ATG 76
16 MHC 2018; 25 (1) 2 HLA HLA 2000 GVT: graft versus tumor HLA HLA TRUMP 7 18 19 4 12 6 4 3 1 16 7 7 11 4 2 1 10 5 2 1 1 stage4 M3 1 3 3 6 11 2 2 3 Thiotepa/Melphalan Busulfan Fludarabine Cyclophosphamide/ Melphalan Fludarabine 2 GVHD Tacrolims+short MTX 2 VOD, ARDS GVHD II-IV 3 5 GVHD 3 17 6 1 2 1 3 1 2 1 1 5 10 5 85% 38% GVHD 77
MHC 2018; 25 (1) 16 3 HLA HLA Graft-versus-host disease, GVHD HLA HLA-A, -B, -C, -DRB1 1 HLA-A, HLA-B GVHD HLA WG HLA1 1993 1999 HLA-B 2000 2009 GVHD HLA GVHD HLA 2002 1 GVHD 8 1 GVHD 5 10% HLA WG anti-thymocyte globulin, ATG ATG thymoglobulin 2.5 mg/kg ATG GVHD ATG HLA ATG ATG GVHD HLA HLA1 ATG thymoglobulin 2.5 mg/kg 78
16 MHC 2018; 25 (1) 15:40 15:50 休憩 15:50 17:20 シンポジウム (2) 1 2 HLA 3 79
MHC 2018; 25 (1) 16 1 1) 2) 2) 1) 2) Antibody Mediated Rejection AMR HLA Donor Specific Antibody DSA Single Antigen Beads HLA AMR DSA DSA overflow AMR AMR 16 8 8 46.3 17.0 peripheral blood mononuclear cells PBMCs Single Antigen Beads IgG DSA 1 IgM DSA IgG DSA 20 ml IgM DSA 8 ml PBMCs IgG DSA IgM DSA 80
16 MHC 2018; 25 (1) 2 HLA 1) 1) 1) 2) 2) 1) 1) 2) 3) 1) 1) 2) 3) HLA Donor Specific Antibodies: DSA AMR DSA 1 60% AMR DSA AMR HLA DSA DSA IPTH 2009 10 2016 12 329 CDC FCXM HLA Single Antigen Beads Luminex DSA DSA Rituximab AMR DSA C4d 2009 12 2016 12 1 DSA 20 355 20 242 DSA IPTH 34 DSA Single Antigen Beads Luminex CDC 8 FCXM 14 Luminex DSA 33 4 CDC AMR IVIG 3 1 DSA 83.9% DSA 82.9% p=0.54 De novo DSA 17% 38% DSA 50% DSA 3% DSA p=0.001 DSA 41.4% DSA 22.4% p=0.04 IPTH DSA 12% DSA AMR AMR DSA AMR IPTH DSA 81
MHC 2018; 25 (1) 16 3 1) 1) 1) 1) 1) 2) 2) 2) 1) 1) 2) CDC T-cell MFI HLA FCM HLA A, B, C, DR, DQ, DP HLA LABScreen Mixed Single Antigen CDC FCM HLA HLA MFI<5000 71 2 DSA MFI CDC, FCM 80 2 DSA DQ 1 FCM DSA CDC, FCM 1 1 HLA HLA A, B, DR FCM 82