Partial chimerism after T-cell-depleted allogeneic bone marrow transplantation in leukemic HLA-matched patients: a cytogenetic documentation.
Partial chimerism after T-cell-depleted allogeneic bone marrow transplantation in leukemic HLA-matched patients: a cytogenetic documentation.
复制标题
白血病 HLA 匹配患者 T 细胞耗尽同种异体骨髓移植后的部分嵌合：细胞遗传学文献。
作者：
M. Berthéas;D. Maraninchi;M. Lafage;J. Fraisse;D. Blaise;A. Stoppa;G. Michel;C. Brizard;M. Gaspard;G. Novakovitch
采用细胞遗传学方法，对38例白血病受者进行了大剂量烷化剂和分次全身照射（2.2戈伊× 5）制备的HLA相合骨髓移植（BMT）后的血液和骨髓嵌合体进行了动态观察。通过检查32例患者的性染色体或通过评价6例患者特异性显带后的其他染色体的多态性来鉴定供体或宿主有丝分裂。24例患者接受未经治疗的BMT，14例接受T细胞耗竭的BMT。在接受未经治疗的BMT的24名患者中，所有患者均显示成功的植入，只有3名患者存在短暂的混合嵌合体。在14名T细胞缺失骨髓移植的接受者中，4名接受者出现移植排斥反应，7名接受者出现混合嵌合体;这些混合嵌合体在血液淋巴细胞中比在骨髓细胞中更常见，并且可以在骨髓移植后26个月内检测到。与对照组相比，T细胞耗竭BMT后部分嵌合体的频率较高，表明供体的T细胞在同种异体BMT后宿主残留造血的根除中起重要作用。
We evaluated serially by cytogenetics the blood and marrow chimerism of 38 leukemic recipients of HLA-matched bone marrow transplants (BMT) who were prepared by high doses of alkylating agents and fractionated total-body irradiation (2.2 Gy X 5). Donor or host mitoses were identified by examination of sex chromosomes in 32 patients or by evaluation of the polymorphism of other chromosomes after specific banding in six patients. Twenty-four patients were recipients of untreated BMT, and 14 were recipients of T-cell-depleted BMT. In the 24 patients who received untreated BMT, all showed successful engraftment, and only three had a transient mixed chimera. In the 14 recipients of T-cell-depleted BMTs, four rejected their grafts, and seven had mixed chimeras; these mixed chimeras were more frequent in blood lymphocytes than in marrow cells and could be detected up to 26 months after BMT. This high frequency of partial chimerism after T-cell-depleted BMT by comparison with a control group suggests that the donor's T cells play an important role in the eradication of host residual hematopoiesis after allogeneic BMT.