Miura Y, Tanaka J, Toubai T, Tsutsumi Y, Kato N, Hirate D, Kaji M, Sugita J, Shigematsu A, Iwao N, Ota S, Masauzi N, Fukuhara T, Kasai M, Asaka M, Imamura M
Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Bone Marrow Transplant. 2006 May;37(9):837-43. doi: 10.1038/sj.bmt.1705352.
We analyzed donor-type chimerism in CD3+, CD14.15+ and CD56+ cells from 36 patients who had undergone conventional-intensity allogeneic stem cell transplantation (CST) and 34 patients who had undergone non-myeloablative allogeneic stem cell transplantation (NST) for hematological malignancies. On day 28 after transplantation, all fractions in NST patients and CD3+ cells in CST patients who received a non-total body irradiation (TBI) regimen showed more frequent mixed chimerism (<90% donor cells) than those in patients who had received TBI. NST patients with acute graft-versus-host disease (grade II-IV) frequently showed more than 50% donor-type chimerism in CD3+ cells on day 14 (P=0.029). NST patients with <50% donor-type chimerism on day 14 and with <90% donor-type chimerism on day 28 in CD56+ cells had significantly poor 1-year overall survival (0 vs 91%, P<0.001 and 20 vs 74%, P=0.002, respectively). Both NST and CST patients with <90% donor-type chimerism in CD14.15+ cells on day 28 had significantly poor 1-year overall survival (14 vs 70%, P=0.005 and 0 vs 66%, P=0.002, respectively). Our data show that the extent of donor-type chimerism in lineage-specific cells appears to have an impact on outcome after allogeneic stem cell transplantation.
我们分析了36例接受传统强度异基因干细胞移植（CST）的患者以及34例接受非清髓性异基因干细胞移植（NST）治疗血液系统恶性肿瘤患者的CD3⁺、CD14⁺/15⁺和CD56⁺细胞中的供体型嵌合情况。移植后第28天，接受非全身照射（TBI）方案的NST患者的所有细胞组分以及CST患者的CD3⁺细胞中，混合嵌合（供体细胞<90%）比接受TBI的患者更为常见。发生急性移植物抗宿主病（II-IV级）的NST患者在第14天时，CD3⁺细胞中供体型嵌合率经常超过50%（P = 0.029）。第14天时CD56⁺细胞中供体型嵌合率<50%且第28天时<90%的NST患者，其1年总生存率显著较差（分别为0%对91%，P<0.001；20%对74%，P = 0.002）。第28天时CD14⁺/15⁺细胞中供体型嵌合率<缺90%的NST和CST患者，其1年总生存率均显著较差（分别为14%对70%，P = 0.005；0%对66%，P = 0.002）。我们的数据表明，谱系特异性细胞中供体型嵌合的程度似乎对异基因干细胞移植后的结局有影响。
