Abstract:

Objective    To investigate the correlation of the HLA-DRB1*1501 phenotype and TNF-a-308G/A gene polymorphism with response to immunosuppressive therapy for aplastic anemia(AA). Methods    Phenotypes of HLA-DRB1*1501 and polymorphisms of TNF-a-308 were respectively determined by PCRSSP and PCR-RFLP in 40 AA patients initially treated with immunosuppressive therapy based on cyclosporine (CsA).The relation between laboratory indexes and clinical response was investigated. Results    The response rates to immunosuppressive therapy of HLA-DRB1*1501+ and HLA-DRB1*1501 were 12/14(85.7%) vs 12/26(46.2%) (P=0.024), and of TNF-a-308A(TNF2)+and TNF2- were 11/14(78.6%) vs 13/27(48.1%)(P=0.039). Prediction probabilities of the four groups (HLA-DRB1*1501+TNF2+, HLA-DRB1*1501+TNF2, HLA-DRB1*1501-TNF2+ and HLADRB1*1501-TNF2) were 0.963, 0.785, 0.754 and 0.354 respectively.  Conclusion   The combined measurement of HLA-DRB1*1501  and TNF-a（308A）could be a predictor of response to immunosuppressive therapy for aplastic anemia and valuable for clinical application.

Key words: Anemia, aplastic; Tumor necrosis factor; Gene polymorphism;  HLA phenotype