STR-PCR在异基因造血干细胞移植中植入效果监测的应用

目的：建立适用于重庆地区造血干细胞移植后监测的 PCR扩增荧光标记短串联重复序列（STR‐PCR）检测方法，为造血干细胞移植疗效评价提供可靠依据。方法收集术前供者、受者EDTA抗凝静脉血及受者术后不同时间EDTA抗凝静脉血，采用STR‐PCR技术对65例allo‐HSCT患者的15个STR位点和1个性别位点进行分析。结果65例异基因造血干细胞移植术的病例，术后检测患者S T R位点呈现受者源、供者源和供受者嵌合3种状态，有54例的移植后监测呈现供者源状态，8例移植后监测到嵌合体状态，3例移植后监测呈现受者源状态，且发现3种状态之间可相互转化，每种状态的最早检出时间和持续时间及转化时间存在差异，其中出现供者源状态的最早时间是术后第17天，持续最长时间为7多个月。而出现嵌合状态的最早时间为术后第16天，最晚在移植后5个月才监测到嵌合。在嵌合持续时间上，持续时间最短为2个月，持续时间最长者达7个月。结论 allo‐HSCT患者术后STR位点转化情况存在差异，要建立起适用于该地区的STR‐PCR方法需要正确留取供受者标本，同时应掌握好恰当的检测时机和适宜的STR位点。

Application of STR-PCR in monitoring the effect of allogeneic hematopoietic stem cell transplantation

Objective To establish multiple short tandem repeat (STR) amplification by fluorescence labeling polymerase chain reaction (PCR) for monitoring the effect of allogeneic hematopoietic stem cell transplantation .Methods Sixty‐five patients were analyzed .DNA from peripheral blood of donors and recipients in pre transplantation and post transplantation were extracted , 15 STR loci and sexual loci were amplified by PCR .Results After allo‐HSCT ,54 patients obtained type of donors ,but 3 patients did not ;eight patients showed mixed chimerism .Two cases of type of donor converted into mixed chimerism and two cases of mixed chimerism converted into type of donors after some time .The time of earliest detection ,duration and transformation of each state was different .The earliest detection showed on the 16th day after surgery ,and the last one showed five months later .As to the du‐ration ,the shortest and longest were two months and seven months ,respectively .Conclusion The key factors that significantly in‐fluence the application of STR‐PCR in monitoring the effect of allogeneic hematopoietic stem cell transplantation were samples ,STR loci and proper monitoring time .So to establish the suitable method for this region could truly take maximum advantage of the PCR‐STR method .While a appropriate detecting time and STR loci should be chose .