Ruiz Azulamara da Silva, Chauffaille Maria de Lourdes Ferrari, Alves Solivanda Trindade, Oliveira José Salvador Rodrigues de
Division of Hematology and Transfusion Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2009 Sep;127(5):251-8. doi: 10.1590/s1516-31802009000500002.
Non-myeloablative hematopoietic stem cell transplantation (NMA-HSCT) is performed in onco-hematological patients who cannot tolerate ablative conditioning because of older age or comorbidities. This approach does not completely eliminate host cells and initially results in mixed chimerism. Long-term persistence of mixed chimerism results in graft rejection and relapse. Involvement of graft-versus-host disease is concomitant with complete chimerism and graft-versus-tumor effect. The aim of this study was to evaluate the prevalence of chimerism in onco-hematological patients who underwent NMA-HSCT.
Observational clinical study on chimerism status after human leukocyte antigen-identical NMA-HSCT at the Discipline of Hematology and Hemotherapy of Universidade Federal de São Paulo.
We sequentially analyzed the amplification of APO-B, D1S80, DxS52, FVW, 33.6, YNZ-2 and H-ras primers using variable number of tandem repeats (VNTR) on 17 pairs and fluorescent in situ hybridization (FISH) with the XY probe and SRY primer on 13 sex-unmatched pairs.
The informativeness of the primers using VNTR was 60% for APO-B, 75% D1S80, 36% DxS52, 14% FVW, 40% YNZ-22 and 16% H-ras. The SRY primer was informative in female receptors with male donors. The XY-FISH method was informative in 100% of the sex-unmatched pairs.
These methods were sensitive and informative. In VNTR, the association of APO-B with D1S80 showed 88% informativeness. The quantitative FISH method was more sensitive, but had the disadvantage of only being used for sex-unmatched pairs.
非清髓性造血干细胞移植（NMA - HSCT）适用于因年龄较大或合并症而无法耐受清髓预处理的肿瘤血液科患者。这种方法不能完全清除宿主细胞，最初会导致混合嵌合体。混合嵌合体的长期持续存在会导致移植物排斥和复发。移植物抗宿主病的发生与完全嵌合体及移植物抗肿瘤效应相关。本研究的目的是评估接受NMA - HSCT的肿瘤血液科患者中嵌合体的发生率。
圣保罗联邦大学血液学与血液治疗学科对人类白细胞抗原匹配的NMA - HSCT后嵌合体状态进行的观察性临床研究。
我们依次分析了17对样本中使用可变数目串联重复序列（VNTR）的载脂蛋白B（APO - B）、D1S80、DxS52、FVW、33.6、YNZ - 2和H - ras引物的扩增情况，以及13对性别不匹配样本中使用XY探针和SRY引物的荧光原位杂交（FISH）情况。
使用VNTR的引物的信息率分别为：APO - B为60%，D1S80为75%，DxS52为36%，FVW为14%，YNZ - 22为40%，H - ras为16%。SRY引物在女性受者与男性供者的配对中具有信息价值。XY - FISH方法在100%的性别不匹配样本中具有信息价值。
这些方法灵敏且具有信息价值。在VNTR中，APO - B与D1S80联合使用时信息率为88%。定量FISH方法更灵敏，但缺点是仅适用于性别不匹配的样本。
