异基因骨髓移植后嵌合状态的研究进展

Progress of Chimerism Reserch after Allo-Bone Marrow Transplantation

骨髓移植是许多血液系统疾病和免疫缺陷性疾病的有效治疗措施 ,移植成功与否与供者细胞在受者体内的植入状况即嵌合状态的形成有关。由于造血干细胞输入量、供者和受者T细胞量、预处理方案以及移植时患者病情等因素的影响 ,可以形成不同形式的嵌合状态。如果受者的骨髓或外周血中完全是供者的细胞 ,则形成完全的供者嵌合状态 (CC) ;当检测到供者和受者两种细胞成分时 ,则为混合嵌合状态 (MC)。不同形式的嵌合状态 ,以及嵌合状态形式的不同演变趋势 ,其临床意义各不相同。检测嵌合状态的方法有多种 ,包括微卫星检测、染色体核型分析、血型转换、红细胞抗原、限制性片段长度多态性、可变数目串联重复序列以及现在最常用的PCR法。

Bone marrow transplantation (BMT) is an effective therapy for a variety of hematologic and immunodeficient diseases. Two possible situations of chimerism can be encountered when assessing the hematological status in recipient post allo BMT: 1. complete chimerism, where the marrow and circulating blood cells all are donor origin; and?2. mixed chimerism, the cell components in recipient are both donor and recipient origins. Formation of the different kinds of chimerism are influenced by some factors, included the amount of infused hematopoietic stem cells, the ratio of T cells from donor and recipient, conditioning regimen and patient′s condition. The clinical significance was different for the forms and development of chimerism. There are several detecting methods for chimerism, such as microsatellite assay, karyotyping of chromosome, conversion of blood group, red blood cell antigen, restriction fragment length polymorphism, variable number of tandem repeat, and PCR. Above mentioned aspects of chimerism research were reviewed.