嵌合体监测与供者淋巴细胞输注在地中海贫血患者移植后排斥风险中的作用

Role of Chimerism Monitoring and Donor Lymphocyte Infusion in Eliminating the Risk of Graft Rejection Following HSCT in Thalassemia Patients——Review

造血干细胞移植(hematopoietic stem cell transplantation,HSCT)治疗重型β-地中海贫血的主要障碍之一是移植后排斥反应(graft rejection,GR),混合性嵌合体中供者来源细胞比例持续下降,最终导致移植失败。移植后连续性嵌合体的监测能够早期发现不稳定混合嵌合体和排斥反应,为供者淋巴细胞输注(donor lymphocyte infusions,DLI)提供依据;应用渐增供者淋巴细胞数输注对早期排斥反应进行干预,可以使嵌合体趋于稳定。本文就重型β-地中海贫血患者HSCT后嵌合体监测与供者淋巴细胞输注的研究进展作一综述。

one of the major obstacle for hematopoietic stem cell transplantation （HSCT） to treat patients with beta- thalassemia is graft rejection （GR）. The proportion of donor-derived cells continually declined in mixed chimerism （ MC）, finally leading to graft failure. Monitoring chimerism after transplant consecutively can early find unstable mixed chimerism and rejection, which provide the basis for donor lymphocyte infusion （DLI） ; for imminent risk of graft rejection,escalating doses of DLI is a feasible method for converting unstable MC towards stable MC or full donor chimerism. This review focuses on advancement of chimerism monitoring and DLI after HSCT for patients with β- thalassemia major.