Xu Kai-lin, Ju Jian-ping, Pan Xiu-ying, Du Bing, Li Zhen-yu, Lu Qun-xian
Department of Hematology, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China.
Zhonghua Xue Ye Xue Za Zhi. 2003 Jul;24(7):372-5.
To establish strategies for preventing graft versus host disease (GVHD) and reducing treatment associated morbidity while preserving graft versus leukemia (GVL) effect in nonmyeloablative allogeneic bone marrow transplantation (allo-BMT), with or without donor lymphocyte infusion (DLI) after BMT.
3 x 10(7) bone marrow cells mixed with 1 x 10(7) spleen cells from the same BALB/c mouse were transplanted into the nonablative irradiated inbred 615 mouse which received a single subcutaneous injection of 1 x 10(6) L615 leukemia cells three days before. The experiments were designed as follows (ten mice in each group): myeloablative BMT control group (group A), nonmyeloablative conditioning without BMT group (group B), nonmyeloablative BMT group (group C), and nonmyeloablative BMT + DLI group (group D). GVL effects were assessed by survival time, white blood cell count and L615 cells in peripheral blood and histologic changes. GVHD was assessed by signs of weight loss, ruffled fur, diarrhea and histologic changes of skin, liver and small intestines. Chimerism was detected by cytogenetic analysis and PCR technique.
The survival time of group A, B, C and D was (20.3 +/- 13.4), (15.9 +/- 1.1), (21.6 +/- 1.7) and (37.8 +/- 2.0) days, respectively, being no significant difference between group A and group C (P > 0.05). The survival time of group C was longer than that of group B (P < 0.01). And among group B, C and D, group D had the longest survival time (P < 0.01). GVHD signs and histologic changes were observed in 60% of control group mice at + 14 day, but none of group C and group D. 40% of mice in group A died of treatment associated morbidity within two weeks, but none in group C and group D. Allogeneic chimerism was kept in group A, but excluded gradually in group C.
GVL effect seems preserved in nonmyeloablative BMT mice, but weaker than that in myeloablative BMT mice. GVL effect seems to be enhanced by DLI after nonmyeloablative BMT. GVHD and transplantation associated morbidity seems to be reduced in nonmyeloablative BMT.
建立在非清髓性异基因骨髓移植(allo - BMT)中预防移植物抗宿主病(GVHD)和降低治疗相关发病率的策略,同时在BMT后有或无供体淋巴细胞输注(DLI)的情况下保留移植物抗白血病(GVL)效应。
将来自同一只BALB/c小鼠的3×10⁷个骨髓细胞与1×10⁷个脾细胞混合,移植到经非清髓性照射的近交系615小鼠体内,该小鼠在三天前皮下注射了1×10⁶个L615白血病细胞。实验设计如下(每组10只小鼠):清髓性BMT对照组(A组)、非清髓性预处理但无BMT组(B组)、非清髓性BMT组(C组)和非清髓性BMT + DLI组(D组)。通过生存时间、外周血白细胞计数和L615细胞以及组织学变化评估GVL效应。通过体重减轻、被毛蓬松、腹泻等体征以及皮肤、肝脏和小肠的组织学变化评估GVHD。通过细胞遗传学分析和PCR技术检测嵌合现象。
A组、B组、C组和D组的生存时间分别为(20.3±13.4)、(15.9±1.1)、(21.6±1.7)和(37.8±2.0)天,A组和C组之间无显著差异(P>0.05)。C组的生存时间长于B组(P<0.01)。在B组、C组和D组中,D组的生存时间最长(P<0.01)。在+14天时,对照组60%的小鼠出现GVHD体征和组织学变化,但C组和D组均未出现。A组40%的小鼠在两周内死于治疗相关并发症,但C组和D组均无。A组保持了异基因嵌合,但C组逐渐排除。
非清髓性BMT小鼠似乎保留了GVL效应,但比清髓性BMT小鼠弱。非清髓性BMT后DLI似乎增强了GVL效应。非清髓性BMT似乎降低了GVHD和移植相关发病率。