, En fonction du mis-match MIC-A
, Nous n'avons mis en évidence aucune relation entre les mis-matchs GVH/GVL, globaux et mis-matchs MIC-A 129, dans la survenue de GVH aiguë ni d'impact sur la survie, contrairement aux études de
, Cependant, les impacts d'un tel mis-match MIC-A entre le donneur et le receveur restent controversés dans la littérature
, Sur une série de 922 allogreffes, Carapito et al. montrent que les mis-matchs MIC-A sont associés à une augmentation de l'incidence de GVH aiguë grades III-IV,de GVH chronique et de la mortalité sans rechute
le taux de GVH aiguë de grades II à IV est plus élevé en présence d'un mis-match MIC-A. Toutefois sa cohorte de 236 allogreffes inclue des greffes 10/10 et, vol.9 ,
où il n'est mis en évidence aucune relation entre MIC-A et GVH sur des cohortes ,
, Cette disparité de résultats peut s'expliquer par l'absence d'homogénéité entre les populations en termes de pathologies et par la différence de taille de l'échantillon. Les données obtenues sont
, Les disparités retrouvées dans la littérature, en comparaison avec notre étude, peuvent s'expliquer par de nombreux autres critères
, Pour l'étude spécifique de l'implication des gènes MIC-A, il faut toutefois veiller à ne pas introduire de cas avec des mis-matchs HLA-B. En effet, il existe un déséquilibre de liaison entre le HLA-B de classe I et le gène MIC-A. Notre cohorte n'est composée que de patients allogreffés en compatibilité 10/10, dont 44.4% ont reçu une greffe géno-identique
, Les mis-matchs HLA-DPB1 sont, en théorie, absents dans les greffes géno-identiques mais sont présents, jusqu'à 80%, dans des greffes phéno-identiques, De plus, peu d'études intègrent la détermination HLA-DPB1 pour définir dans les allogreffes 10/10
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