荧光标记引物复合扩增短串联重复序列技术用于异基因造血干细胞移植植活测定

目的　探讨荧光标记引物复合扩增短串联重复序列技术(fm PCR -STR)在分析异基因造血干细胞移植(allo- SCT)后植活状态中的作用。方法　用fm -PCR- STR技术对 15例allo SCT患者的 15个STR位点和 1个性别位点 (牙釉蛋白基因 )进行分析。结果　12例(5例接受HLA全相合allo- SCT和 7例接受HLA半相合allo SCT)的受者移植后均持续表达完全供者型。1例HLA全相合allo -SCT和 1例HLA半相合allo -SCT在fm PCR -STR动态观察中早期均表现为完全供者型,分别于 82d和 381d转为嵌合型。1例HLA半相合首次移植 31d表达完全受者型(反映移植失败),再次移植 29d表达完全供者型。结论　fm -PCR- STR可敏感且精确地分析allo SCT后移植物植活状态,亦可作为白血病复发的监控手段。

A study on technique of multiplex polymerase chain reaction with fluorescence labeling primers for short tandem repeats to document engraftment following allogeneic stem cell transplantation and its application

Objective To evaluate the application of multiplex polymerase chain reaction technique with fluorescence labeling primers for short tandem repeats(fm-PCR-STR) in the detection of engraftment following allogeneic stem cell transplantation (allo-SCT).Methods Fifteen STR loci and a sex-linked loci (amelogenin) were analyzed by fm-PCR-STR in 15 patients with allo-SCT.Results STR of 12 recipients after allo-SCT continuously presented full donor chimeras,among them 5 patients received grafts from HLA identical sibling donor while 7 received from HLA haplotype-mismatched grafts.During the dynamic observation after transplantation a recipient with HLA identical allo-SCT and a HLA haplotype-mismatched allo-SCT got the evidences of survival of engraftment and presented full donor type,but transformed to mixed chimeras later at 82d and 381d respectively.In another case with HLA haplotype-mismatched graft,STR showed full recipient chimeras at 31d after the first allo-SCT,indicating engraftment failure,but showed full donor chimeras at 29d after the second allo-SCT.Conclutions Analysis of fm-PCR-STR following allo-SCT provided a sensitive and accurate indication on engraftment and monitoring the recrudesce of leukaemia.