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目的分析造血干细胞移植(HSCT)后复发与个体差异的细胞因子高表达的关系。方法分别采集24名异基因造血干细胞移植(allo-HSCT)患者移植前后(-13、0、7、14、21、26和30 d)的系列血样,4名健康人作为对照采集血样周期同患者,分别制备血浆、DNA、RNA;血浆用于细胞因子GM-CSF、IFN-γ、IL-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10及TNF-α检测;DNA用于信息STR位点谱定量分析嵌合物;RNA用于定量检测BCR-ABL融合基因的肿瘤负载。结果信息STR位点谱定量分析嵌合物结合BCR-ABL融合基因的肿瘤负载,确认出4名患者为慢性粒细胞性白血病复发,另有1人根据临床表现诊断为急性粒细胞性白血病复发,1人死于急性移植物抗宿主病。对5名复发患者、18名缓解患者移植前后10种细胞因子浓度(pg/ml)分析发现:复发组与缓解组分别为GM-CSF(57.2±135.8)vs(15.7±37.3)、IL-1β(233.0±330.6)vs(19.2±39.5)、IL-2(178.2±257.0)vs(14.1±41.1)、TNF-α(9.0±18.4)vs(2.6±4.3)、IL-4(28.9±33.5)vs(9.9±10.0),P<0.01),此差异主要是由于5名复发患者中的2例持续高表达IL-1β、IL-2、IL-4,而TNF-α、GM-CSF仅在1例中持续高表达,缓解组18例加上死亡的1例共19例中只有1例GM-CSF持续较高表达。结论 HSCT移植后的复发可能与个体差异的细胞因子高表达相关,且这些细胞因子为成组出现,如IL-1β、IL-2、IL-4同时高表达。建议allo-HSCT患者在移植前后做细胞因子的浓度测定,至少包括IL-1β、IL-2、IL-4。
Objective To analyze the relationship between the relapse after hematopoietic stem cell transplantation (HSCT) and the high expression of cytokines in individuals. Methods Twenty-four blood samples of allo-HSCT patients were collected before and after transplantation (-13, 0, 7, 14, 21, 26 and 30 d) , Plasma, DNA and RNA were prepared respectively; plasma was used to detect cytokines such as GM-CSF, IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL- TNF- [alpha]; DNA was used to quantitatively analyze chimeras in the informative STR locus; RNA was used to quantify the tumor burden of the BCR-ABL fusion gene. RESULTS STR STR SPECTROSCOPY Quantitative analysis of the tumor burden of the chimeric BCR-ABL fusion gene confirmed four patients with recurrent CML and another diagnosed with recurrent acute myeloid leukemia based on clinical manifestations, One died of acute graft-versus-host disease. The levels of 10 cytokines (pg / ml) before and after transplantation in 5 relapsed and 18 remission patients were found to be significantly lower than those in the relapsed and remission groups (57.2 ± 135.8 vs 15.7 ± 37.3, IL-1β (233.0 ± 330.6) vs (19.2 ± 39.5), IL-2 (178.2 ± 257.0) vs (14.1 ± 41.1), TNF-α (9.0 ± 18.4) vs (2.6 ± 4.3) vs (9.9 ± 10.0), P <0.01). The difference was mainly due to the sustained high expression of IL-1β, IL-2 and IL-4 in 2 of 5 recurrent patients, while TNF- One case of sustained high expression, remission group of 18 cases plus 1 case of death in a total of 19 cases, only 1 case of GM-CSF sustained high expression. Conclusion The recurrence after HSCT may be related to the high expression of different cytokines. These cytokines appear in groups, such as high expression of IL-1β, IL-2 and IL-4. It is recommended that allo-HSCT patients be assayed for cytokine concentrations before and after transplantation, including at least IL-1β, IL-2 and IL-4.