HLA-B位点不合两份脐血混合移植植入状态的动态观察

Dynamic observation on engraftment status of transplantation with two units of HLA-B mismatched umbilical cord blood.

目的动态观察分析两份HLA不全相合异基因混合脐血移植后的植入状态。方法一例成人急性髓细胞白血病患者采用了两份HLA-B位点不全相合非血缘脐血移植(脐血1有核细胞数为2.5×107/kg,脐血2有核细胞数为1.53×107/kg),对其移植前、移植后15天、30天、52天和69天的外周血进行HLA及STR基因两种遗传学标记物的检测。采用PCR-SSP基因分型试剂盒对HLA-B位点进行差异分析,用“ProfilerPlus”及“Cofiler”试剂盒检测15个STR位点,对移植前后的检测结果进行对比分析。结果HLA及STR检测均显示移植后15天、30天基因型为完全两份脐血的嵌合型,移植后52天、69天只表达脐血1的基因型。结论两份脐血移植初期可同时植入,而后其中有核细胞数高的一份脐血可长期植入。HLA及STR基因作为植入证据为临床脐血混合应用及治疗提供了直接的实验依据。

Objective To observe and analyse the dynamic changes of engraftment status after transplantation of mixed umbilical cord blood from two units HLA one locus mismatched.Methods An adult with acute myeloid leukemia received two units HLA-B locus mismatched unrelated umbilical cord blood transplantation(2.5×10 7 nucleated cells /kg in umbilical cord blood1,and1.53×10 7 nucleated cells /kg in umbilical cord blood2).HLA and STR were detected before and after transplantation at day15,day30,day52and day69respectively.HLA-B locus distinct analysis was assayed by PCR-SSP genotyping kit and15loci of STR were detected by″Profiler Plus″and″Cofiler″kit.The results of before and after transplantation were compared and analyzed.Results Both STR and HLA assay revealed a complete chimerism of two umbilical cord blood at day15and day30,however,only the genotype of umbilical cord blood1was expressed at day52and day69.Conclusions Two umbilical cord blood can be engrafted simul-taneously in the initial stage,but subsequently only the one with higher nucleated cells Can existe in the logn-term.Therefore,HLA and STR genotyping may provide direct experimental basis for clinical application and therapy of mixed umbilical cord blood.