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异基因造血干细胞移植后嵌合状态的追踪监测
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作者：张庆霞 严江伟 焦章平 唐晖 霍振义 王静 高俊薇 杨剑 朱晓君 马万山 贾淑琴 刘雅诚
【关键词】 异基因造血干细胞移植；串联重复序列；基因扩增；嵌合状态
A tracking detection on chimerism after allogeneic hematopoietic stem cell transplantation
【Abstract】AIM: To evaluate the chimerism after allogeneic hematopoietic stem cell transplantation by analysing multiloci of short tandem repeats (STR). METHODS: Thirtyone patients who had received allogeneic hematopoietic stem cell transplantation were evaluated.Their 9 STR loci and Amelogenin gene were amplified by fluorescent multiplex PCR. PCR products were separated by using DNA Sequencer and analyzed by using GeneScan and Genotyper. RESULTS: Seven patients showed full donor chimeras at the first test, and converted into mixed chimeras at the last test; 4 of them died, and the others relapsed. Four patients blood changed from full donor chimeras to full receptor genotype. One patient changed from mixed chimeras to full donor chimeras, and he had no evidence of relapse. One patient had mixed chimerism at all times and died. Eighteen of the 31 patients had full donor chimeras at all times, and 16 of them survived leukemiafreely, but 2 died. CONCLUSION: The system of fluorescent multiplex amplification of STRs had a high power of discrimination, and this detection method is sensitive, exact and rapid. It is a valuable tool for studying the engraftment, graft rejection, and relapse after allogeneic hematopoietic stem cell transplantation. At the same time, it is necessary to combine it with the clinical syndrome, and to detect STR of the patient’s blood earlier, for providing a basis for early intervention of clinical treatment.
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