STR-PCR半定量检测嵌合体方法在非清髓异基因造血干细胞移植中的应用.docVIP

STR-PCR半定量检测嵌合体方法在非清髓异基因造血干细胞移植中的应用 【摘要】 目的 应用 STR-PCR半定量嵌合体检测 方法 监测非清髓异基因造血干细胞移植（non-myeloablative allogenEic stem cell tansplantation，NAST）后嵌合体。方法 采用短串联重复序列-聚合酶链反应（STR-PCR）结合聚丙烯酰胺凝胶电泳和银染色以及凝胶成像 分析 技术对28例接受NAST的患者进行嵌合体监测。结果 27例患者形成造血细胞嵌合体，完全嵌合（complete chimerism，CC）22例，混合嵌合（mixed chimerism，MC）5例；其中低比例嵌合（low level of mixed chimerism，LMC）3例，高比例嵌合（high level of mixed chimerism，HMC）2例。稳定植入的患者+7天即达HMC，3例患者复发前检测到供体细胞嵌合率（donor cell，DC）下降，1例在CC状态下复发，1例LMC发生早期移植排斥，长期存活者均保持稳定CC。嵌合体监测下早期接受临床干预 治疗 的MC患者转化为CC并延长了无病生存期。结论 STR-PCR是一种简单、敏感、 经济 的监测非清髓移植后嵌合体的方法。 熊辉霞（1977～），女，汉族，青海籍，主治医师，硕士 【关键词】 短串联重复序列 非清髓造血干细胞移植 造血嵌合体 Abstract Objective To investigate the value of semi-quantitative analysis of chimerism after non-myeloablative allogenEIc stem cell tansplantation(NAST) by short tandem repeat-polymerase chain reaction(STR-PCR). Methods 28 patients received NAST were evaluated. Semi-quantitative assessment of hematopoietic chimerism was performed by STR-PCR, polyacrylamide gels, silver staining and detected by Image Analysis System. Results 27 cases formed hematopoietic chimerism, 22 cases formed complete chimerism(CC) and 5 cases were of mixed chimerism(MC), 3 cases formed low level of mixed chimerism(LMC) and 2 cases were high level of mixed chimerism(HMC). Patients with stable engraftments showed HMC on day +7. Before the time of relapse, STR-PCR indicated decrease of donor cell(DC) in 3 patients. One patient relapsed in CC status and another patient with LMC rejected grafts earlier. Patients with persistent CC were associated with a longer disease-free time. Patients received an early intervention of clinical treatment transferred from MC to CC or got a longer disease-free time. Conclusion STR-PCR provide a simple, sensitive and economic approach for monitoring of chimerism after transplantation. Key words short tandem repeats Non-myeloablative stem cell transplantation Nematopoietic chimerism 非清髓异基因造血干细胞移植（NAST）由于减量的放、化疗预处理加上强效的免疫抑制，移植后多形成供、受体细胞不同比例的混合嵌合体，并呈动态变化［1, 2］。嵌合