The evolution of malignant and reactive γδ + T cell clones in a relapse T-ALL case after allogeneic stem cell transplantation.

The evolution of malignant and reactive γδ + T cell clones in a relapse T-ALL case after allogeneic stem cell transplantation.
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DOI:
10.1186/1476-4598-12-73
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发表时间:
2013-07-12
期刊:
影响因子:
37.3
通讯作者:
Li Y
Li Y
中科院分区:
医学1区
文献类型:
--
作者:
Chen S;Huang X;Zheng H;Geng S;Wu X;Yang L;Weng J;Du X;Li Y

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为了改善T细胞急性淋巴细胞白血病(T-ALL)患者的预后,需要对T-ALL母细胞的生物学特性和T-ALL患者的免疫状态进行表征,以确定特定的治疗策略。我们使用一种基于精细拼接比较基因组杂交(FT-CGH)和连接介导PCR(LM-PCR)相结合的新方法,在复发性T-ALL患者中分子鉴定了一个具有Vδ5Dδ 2 J δ1重排的恶性γδ + T细胞克隆,该克隆与T细胞受体(TCR)VγI配对,并包含Vγ1Vδ5 T细胞克隆。这种恶性Vδ5 T细胞克隆在化疗后消失,但在异基因造血干细胞移植(allo-HSCT)后100周疾病复发时再次检测到该克隆。使用PCR和GeneScan分析,检查了患者allo-HSCT前后TCR Vγ和Vδ亚家族的分布和克隆性。在不同时间点(即,allo-HSCT后4、8、68、100和108周)。在allo-HSCT后完全缓解(CR)期间和疾病复发时,该Vδ4+ T细胞克隆的表达在患者中更高。本研究建立了一种灵敏的检测T细胞亚克隆的方法,可用于监测微小残留病和免疫重建。
To improve the outcome of patients with T-cell acute lymphoblastic leukemia (T-ALL), characterization of the biological features of T-ALL blast cells and the immune status of patients with T-ALL is needed to identify specific therapeutic strategies. Using a novel approach based on the combination of fine-tiling comparative genomic hybridization (FT-CGH) and ligation-mediated PCR (LM-PCR), we molecularly identified a malignant γδ + T cell clone with a Vδ5Dδ2Jδ1 rearrangement that was paired with a T cell receptor (TCR) VγI and comprised a Vγ1Vδ5 T cell clone in a relapse T-ALL patient. This malignant Vδ5 T cell clone disappeared after chemotherapy, but the clone was detected again when disease relapsed post allogeneic hematopoietic stem cell transplantation (allo-HSCT) at 100 weeks. Using PCR and GeneScan analyses, the distribution and clonality of the TCR Vγ and Vδ subfamilies were examined before and after allo-HSCT in the patient. A reactive T cell clone with a Vδ4Dδ3Jδ1 rearrangement was identified in all samples taken at different time points (i.e., 4, 8, 68, 100 and 108 weeks after allo-HSCT). The expression of this Vδ4+ T cell clone was higher in the patient during complete remission (CR) post allo-HSCT and at disease relapse. This study established a sensitive methodology to detect T cell subclones, which may be used to monitor minimal residual disease and immune reconstitution.
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