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异基因干细胞移植后嵌合分析的相关性

Relevance of Chimerism Analysis After Allogeneic Stem Cell Transplantation.

作者信息

Clemente I, Goncalo A, Faria C, Dias M, Barbosa I, Mendes C

机构信息

Cancer Genetics Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal.

Laboratory Hematology Service, Portuguese Institute of Oncology of Porto (IPO-Porto), Porto, Portugal.

出版信息

Transplant Proc. 2017 May;49(4):890-892. doi: 10.1016/j.transproceed.2017.01.065.

Abstract

Hematopoietic stem cell transplantation is a potentially curative therapy for a range of malignant and non-malignant hematological diseases. Analysis of chimerism following allogeneic stem cell transplantation has been a routine method for the assessment of engraftment and early detection of graft failure. Lineage-specific chimerism monitoring is progressively used to specifically detect chimerism in one or more cell subsets, which may be undetected in assessment of the whole leukocyte population. The chimerism study in different leukocyte subpopulations increases sensitivity and specificity in the monitoring after transplantation, especially the analysis of T lymphocytes. All peripheral blood samples were separated into mononuclear cells and granulocytes by Ficoll density gradient centrifugation and T, B, and CD34+ was separated by immunomagnetic automatic cell separator. After DNA extraction, chimerism monitoring was performed using short tandem repeat by multiplex polymerase chain reaction followed by capillary electrophoresis. Quantification of chimerism was performed by determining the ratio of peak areas from donor and recipient informative short tandem repeat. Donor-recipient chimerism analysis in patients after allogeneic stem cell transplantation is a practical, feasible, and useful tool that predicts clinical outcomes and provides a guide for suitable therapeutic interventions.

摘要

造血干细胞移植是治疗一系列恶性和非恶性血液疾病的一种潜在的治愈性疗法。异基因干细胞移植后嵌合状态的分析一直是评估植入情况和早期检测移植失败的常规方法。谱系特异性嵌合状态监测正逐渐用于特异性检测一个或多个细胞亚群中的嵌合状态,而在评估整个白细胞群体时可能无法检测到这种情况。对不同白细胞亚群的嵌合状态研究提高了移植后监测的敏感性和特异性,尤其是对T淋巴细胞的分析。所有外周血样本通过Ficoll密度梯度离心法分离为单核细胞和粒细胞,并通过免疫磁珠自动细胞分离器分离出T细胞、B细胞和CD34+细胞。DNA提取后,采用多重聚合酶链反应结合毛细管电泳的短串联重复序列进行嵌合状态监测。通过确定供体和受体信息性短串联重复序列的峰面积比来进行嵌合状态的定量分析。异基因干细胞移植患者的供体-受体嵌合状态分析是一种实用、可行且有用的工具,可预测临床结果并为适当的治疗干预提供指导。

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