Wang L-J, Chou P, Gonzalez-Ryan L, Huang W, Haut P R, Kletzel M
Immunogenetics and Stem Cell Transplantation Laboratory, Division of Hematology and Oncology, Department of Pediatrics, Northwestern University Medical School, Children's Memorial Hospital, Chicago, IL, USA.
Bone Marrow Transplant. 2002 Jan;29(1):51-6. doi: 10.1038/sj.bmt.1703333.
In order to monitor the clinical outcome of pediatric patients with leukemia following allogeneic hematopoietic transplantation, tests of variable number of tandem repeat (VNTR) and sex determination by quantitative polymerase chain reaction (PCR) were performed. PCR results combined with the blast counts from 21 leukemia patients were analyzed. Complete chimerism (100% donor cells) was found in 15 cases with remission, and incomplete chimerism in six cases with relapse. In the majority of cases, complete chimerism was always associated with no detectable blasts, while blasts were often detected in association with incomplete chimerism. There is significant correlation (P<0.0001) between the percentage of donor DNA and blast percentage in these patients. Early detection of incomplete chimerism may therefore predict a poor prognosis. In one patient (case 15), a differing percentage of donor DNA was observed between samples of bone marrow and peripheral blood collected on the same day. This may be due to the fact that allogeneic stem cells proliferate at different rates depending on their environment (bone marrow or peripheral blood). In addition, 100% donor cells found in the peripheral blood may not reflect the number of cells in the bone marrow. In case 17, asynchronous engraftment of donor cells was present between the white and red blood cell lineages, indicating that the degree of chimerism may not be the same in all cell lineages. At the time of this report, the significance of this observation is unknown and needs further investigation.
为监测异基因造血干细胞移植后白血病患儿的临床结局，进行了可变数目串联重复序列（VNTR）检测及定量聚合酶链反应（PCR）性别鉴定。结合21例白血病患者的原始细胞计数分析PCR结果。15例缓解患者中发现完全嵌合（100%供体细胞），6例复发患者中发现不完全嵌合。在大多数情况下，完全嵌合总是与无可检测到的原始细胞相关，而原始细胞常与不完全嵌合相关。这些患者中供体DNA百分比与原始细胞百分比之间存在显著相关性（P<0.0001）。因此，早期检测到不完全嵌合可能预示预后不良。在1例患者（病例15）中，同一天采集的骨髓和外周血样本中观察到供体DNA百分比不同。这可能是由于异基因干细胞根据其所处环境（骨髓或外周血）以不同速率增殖。此外，外周血中发现的100%供体细胞可能无法反映骨髓中的细胞数量。在病例17中，供体细胞在白细胞和红细胞谱系之间存在不同步植入，表明嵌合程度在所有细胞谱系中可能不一样。在本报告发布时，这一观察结果的意义尚不清楚，需要进一步研究。
