红细胞嵌合体定量检测及在异基因造血干细胞移植中的应用  

Quantitative detection of red blood cell chimerism and its application in allogenetic hematopoietic stem cell transplantation

作　　者：翟菊萍[1] 顾国浩[1] 王雪明[1] 蒋敏[1] 周毓菁[1] 彭群新[1] 虞秀兰[1] 

机构地区：[1]苏州大学附属第一医院检验科,江苏苏州215006

出　　处：《临床检验杂志》2011年第3期188-190,共3页Chinese Journal of Clinical Laboratory Science

摘　　要：目的建立流式细胞术(FCM)定量检测不同ABO抗原红细胞嵌合体方法,探讨其在异基因造血干细胞移植(allo-HSCT)中的应用。方法选取标准A、B和O型RBC在体外按不同的比例两两混合(嵌合体),采用FCM对5例allo-HSCT患者于术前及术后7、15、30、45、60和90 d体内RBC的嵌合体进行相对计数,计算其供体细胞的嵌合率。结果体外混合的RBC嵌合体FCM测定值与理论值无显著性差异(P>0.05)。5例患者移植后7 d均能检测到供体细胞,其中3例患者移植后90 d达到完全嵌合状态(FDC),1例患者移植后30 d,供体细胞的嵌合率为8.9%,移植后40 d疾病复发而死亡,另1例患者供体细胞的嵌合率由移植后60 d的86.5%下降至90 d的23.7%,死于严重感染。结论 FCM能定量检测不同ABO抗原的RBC嵌合体,可应用于临床allo-HSCT后RBC嵌合体的动态监测。Objective To develop a method for quantitative detection of erythrocyte chimera with different ABO blood group antigen in flow cytometry（FCM） and investigate its accuracy in the clinical application for allogenetic hematopoietic stem cell transplantation（allo-HSCT）.Methods Serially diluted,artificial mixed red blood cell chimerisms were analyzed by FCM.The chimerisms were prepared by mixing erythrocytes of type A with type O,type B with type O and type A with type B respectively.The samples of five patients who received allo-HSCT were analyzed by FCM before and after transplantation in different time point（7,15,30,45,60 and 90 days）.The percentage of donor chimerism was counted.Results The results of FCM showed that there was no significant difference between the quantity of artificial mixed erythrocyte and the theoretical values（P0.05）.The donor erythrocytes could be detectable in all the five patients on the day 7 after transplantation.In 3 patients full donor chimerism was formed on the day 90 after transplantation.In a patient the percentage of donor chimerism was 8.9% on the day 30 after transplantation,but the disease relapsed and this patient died on the day 40 after transplantation.In another patient the percentage of donor chimerism showed a decrease from 86.5% on the day 60 to 23.7% on the day 90,who died of severe infection.Conclusion FCM can be used to detect red blood cell chimerism with different ABO antigen exactly and monitor red blood cell chimerism sequentially and quantitatively in allo-HSCT.

关 键 词：ABO抗原 流式细胞术 异基因造血干细胞移植 红细胞嵌合体 

分 类 号：R457.7[医药卫生—治疗学]