造血干细胞移植后植入状态的动态定量监测研究  

Study on Quantitative Monitoring of Engraftment State After Hematopoietic Stem Cell Transplantation

作　　者：金士正[1] 程良红[1] 魏天莉[1] 李茜[1] 李桢[1] 邹红岩[1] 

机构地区：[1]深圳市血液中心输血医学研究所组织配型与免疫遗传研究室,广东深圳518035

出　　处：《国际输血及血液学杂志》2011年第2期104-107,共4页International Journal of Blood Transfusion and Hematology

摘　　要：目的通过对造血干细胞移植后患者的短串联重复多态性序列（short tandem repeats，STR）位点进行定性和定量检测，实时动态监测供体细胞（donercell，DC）的植入程度及嵌合体变化过程。方法采用荧光标记多重PCR扩增技术，对36对移植前供、受者血样及移植后受者不同时间点的血样进行15个STR位点的检测，根据供、受者之间的差异位点判断DC在受者体内的植人情况，进而对患者的移植是否成功以及嵌合体类型[完全供者嵌合体（complete chimerism，CC）或混合嵌合体（mixed chimerism，MC）]进行定性判断；根据混合嵌合体中供、受者细胞的相对数量定量分析供体细胞的植入程度及演变规律。结果36对供受体中检出有差别的STR位点为8～15个（平均为11．9个），移植后患者体内最早可检测到供者STR基因的时间为5～14d（平均为7．56d）。动态监测结果表明36例患者中有31例形成稳定CC，STR位点由受者型向完全供者型转化的平均时间为14．17d[（9～23）d]。有5例形成MC，其中4例为持续MC，l例在移植后49d转为CC并持续保持。结论造血干细胞移植中，供受者STR基因位点的定性和定量检测，不仅可为临床提供判断移植是否成功的早期直接证据，且通过分析移植物的嵌合状态及其变化，有助于预警白血病的复发和原发疾病治疗。Objective To monitor the transplantation level of donor-cell and the variation of the chimera at real-time, according to a qualitative and quantitative detection of the short tandem repeat （STR） loci labeling with fluorescence in the hematopoietic stem cell of transplantation patients. Methods Using multiplex polymerase chain reaction （PCR） method, we detected 15 STR loci labeling with fluorescence in blood samples of 36 donor recipient pairs. According to the different genotypes of STR loci between donors and recipients, we qualitatively evaluated whether the donor cells were successfully transplanted and the type of chimera （mixed or completed）. According to the relative quantity of donor cells and recipient cells in the mixed chimera, we quantitatively analyzed the transplantation level and the variation regularity of the donor cells. Results Eight to fifteen different STR loci were found in the 36 donor recipient pairs （means at 11.9）. The first time of the donor% STR gene which detected in the recipient was range from 5 to 14 days （means at 7.56 days）. The ambulant monitoring results indicated that 31 of 36 recipients were transformed as completed chimera（CC） and the average completely transformed time of STR genotypes from recipient to donor was 14. 17 days （from 9 to 23 days）. Five recipients were found as mixed chimera （MC）, among them, 4 recipients were found as continuous MC and the other one was transformed as continuous CC after 49 days. Conclusion In hematopoietic stem cell transplantation, qualitative and quantitative detection of STR loci in dono-recipient pairs could provide the early direct evidence to evaluate whether the donor cells are successfully transplanted. It also alarms the relapse of leukemia and the treatment of protopathy by analyzing the type and the variation of the chimera.

关 键 词：造血干细胞移植 嵌合体 短串联重复序列 

分 类 号：R733.7[医药卫生—肿瘤]