Chou P M, Olszewski M, Huang W, Silva M, Kletzel M
Department of Pathology, Children's Memorial Hospital, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60614, USA.
Bone Marrow Transplant. 2003 Oct;32(8):825-8. doi: 10.1038/sj.bmt.1704236.
Evaluation of chimerism following allogeneic transplantation has been performed traditionally focusing on two cellular compartments, namely lymphoid and myeloid. However, none has been described so far to evaluate platelet chimerism. In order to achieve full chimerism in all three cellular compartments, we prospectively obtained 138 samples of peripheral blood in 55 patients at different post transplant periods following allogeneic hematopoietic transplantation. Evaluation of chimerism was performed utilizing tests of variable number of tandem repeat (VNTR) and sex determination by quantitative polymerase chain reaction (PCR). Tests for platelet chimerism using platelet-rich plasma were simultaneously analyzed with samples for T-cell lymphoid and myeloid compartments. Complete donor chimerism was noted in 49 of 55 patients (89%), while the remaining six have split chimerism ranging from 34 to 98%. There is significant difference (P=0.0004) between the percentages of donor DNA in all three cellular compartments comparing the means+/-s.e.m. (myeloid 95.60+/-0.9, T-cell lymphocytes 87.6+/-1.9, and the platelets 90.8+/-1.5); however, comparison between the medians is not statistically significant. This study represents an additional step towards achieving full chimerism and the observation may help reduce the number of unnecessary platelet transfusions once chimerism is noted in that cellular compartment.
传统上，对异基因移植后的嵌合体评估主要集中在两个细胞区室，即淋巴样和髓样。然而，目前尚未有用于评估血小板嵌合体的方法。为了在所有三个细胞区室中实现完全嵌合，我们前瞻性地收集了55例患者在异基因造血移植后不同时期的138份外周血样本。利用可变数目串联重复序列（VNTR）检测和定量聚合酶链反应（PCR）进行性别鉴定来评估嵌合体。同时对富含血小板血浆进行血小板嵌合体检测，并与T细胞淋巴样和髓样区室的样本一起分析。55例患者中有49例（89%）出现完全供体嵌合，其余6例为混合嵌合，比例在34%至98%之间。比较三个细胞区室中供体DNA百分比的均值±标准误（髓样95.60±0.9、T细胞淋巴细胞87.6±1.9、血小板90.8±1.5），差异有统计学意义（P = 0.0004）；然而，中位数之间的比较无统计学意义。本研究朝着实现完全嵌合又迈进了一步，这一观察结果可能有助于减少一旦在该细胞区室发现嵌合后不必要的血小板输注次数。
