论文部分内容阅读
为了探讨ABO血型不合的急性白血病非清髓性异基因外周血干细胞移植中红细胞血型血清学检测的临床意义 ,采用红细胞凝集试验方法检测供、受者ABO和MN血型 ,用DianaGelphenotypeRh卡检测Rh血型。移植后观察受者血型和红细胞凝集素效价变化以及用STR PCR方法监测供者细胞植入情况。结果显示 ,4例受者中 2例供者细胞混合嵌合伴血型嵌合 ,其中 1例在移植后 1 0 0天转为完全嵌合 ,血型亦转为供者型。另 2例受者细胞呈供、受混合嵌合体 ,但血型未见转变 ,其中 1例在移植后 1 54天出现移植排斥。红细胞凝集素效价检测显示 ,受者红细胞凝集素效价高者 ,供者细胞植入率低 ,血型不易嵌合。反之 ,效价低者 ,供者细胞植入率高 ,血型易嵌合。结论 :在非清髓外周血干细胞移植 (NAPBSCT)中红细胞血型血清学检测可间接反映移植效果 ,协助确定临床预处理方案和移植后免疫抑制治疗的强度 ,估计预后 ,指导移植期的输血
In order to investigate the clinical significance of erythrocyte serological detection in ABO incompatible acute leukemia non-myeloablative allogeneic peripheral blood stem cell transplantation, the donor and recipient ABO and MN blood type were detected by hemagglutination test and Rh blood type by Diana PhenotypeRh card. The recipient’s blood type and hemagglutinin titer were observed after transplantation, and donor cell engraftment was monitored by STR PCR. The results showed that in 4 recipients, 2 donor chimerism was mixed with chimerism, of which 1 was completely chimerized on day 100 after transplantation and the blood type was changed to donor type. The other 2 recipients showed donor and mixed chimerism, but no changes were found in blood type. One case showed graft rejection after 154 days. Hemagglutinin titer test showed that recipients with high titer of hemagglutinin, donor cell implantation rate is low, the blood type is not easy to chimeric. Conversely, low potency, donor cell implantation rate, easy to chimeric blood group. CONCLUSIONS: Erythrocyte serological detection in non-myeloablated peripheral blood stem cell transplantation (NAPBSCT) can indirectly reflect the effect of transplantation, to help determine the clinical pretreatment regimen and immunosuppressive therapy after transplantation intensity, prognosis, and guide the transfusion of transplanted blood