骨髓移植后早期输注供体免疫细胞对促进植入的效果研究

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目的关于骨髓移植后早期输注供体免疫细胞对促进植入的效果研究。方法选择10只无特定病原体(SPF)级雄性C57BL/6小鼠作为供鼠,自身抗原表型为H-2b,选择10只雌性CB6F1小鼠作为受鼠,自身抗原表型为H-2d/b。将10只受鼠以随机数表法分为对照组与实验组,每组各5只。对照组受鼠实施10~6 EL9611+阿糖胞苷+全身照射+混合骨髓移植治疗,实验组受鼠实施10~6EL9611+骨髓细胞+阿糖胞苷+全身照射+混合骨髓移植+供体免疫细胞输注治疗,观察并比较两组受鼠移植后的白细胞计数、供体细胞植入情况、供体细胞嵌合率及不良反应发生情况。结果 1两组受鼠在照射后4~5天即出现白细胞计数下降,30天内逐渐恢复正常;对照组受鼠移植后40~46天出现白细胞计数一过性下降,实验组受鼠移植后47~58天出现白细胞计数一过性下降,后逐渐升高。2两组受鼠在移植后30、60天外周血中SRY基因的DNA水平聚合酶链反应检测结果均为阳性,且荧光亮度随时间延长而不断增强。3两组受鼠供体CD3~+细胞嵌合率随时间延长而有所提高,实验组受鼠供体CD3~+细胞移植后30、60天嵌合率均显著高于对照组(P<0.05)。4两组受鼠移植后均出现体重下降、脱毛等不良反应。对照组1只小鼠于移植后52天死于移植物抗宿主病,体重自移植后15天起逐渐增加;实验组在观察期间无小鼠死亡,体重自移植后35天起逐渐增加。结论骨髓移植后早期输注供体免疫细胞,可促进供体骨髓细胞植入,提高治疗效果,值得深入研究,可为临床治疗白血病提供新思路。 Objective To study the effect of early infusion of donor immune cells on the promotion of engraftment after bone marrow transplantation. Methods Ten male C57BL / 6 mice without specific pathogen (SPF) were selected as donors. The autoantigen phenotype was H-2b. Ten female CB6F1 mice were selected as recipients. The phenotype of the autoantigen was H-2d / b. Ten rats were divided into control group and experimental group by random number table method, with 5 rats in each group. The control group was treated with 10 ~ 6 EL9611 + cytarabine + whole body irradiation + mixed bone marrow transplantation. The experimental group received 10 ~ 6EL9611 + bone marrow cells + cytarabine + whole body irradiation + mixed bone marrow transplantation + donor immune cells Note treatment, observe and compare the white blood cell count, donor cell engraftment, donor cell chimerism and adverse reactions after transplantation in both groups. Results 1 The white blood cell count of rats in two groups decreased 4 to 5 days after irradiation and gradually returned to normal in 30 days. The white blood cell count decreased 40 to 46 days after transplantation in the control group. In the experimental group, 47 ~ 58 days appeared white blood cell count transient decreased, then gradually increased. 2 The PCR results of DNA level of SRY gene in peripheral blood of both groups were positive at 30 and 60 days after transplantation, and the fluorescence intensity increased with time. The chimerism rate of CD3 ~ + cells in both groups increased with time, and the chimeric rates of CD3 + cells in experimental group were significantly higher than those in control group at 30 and 60 days after transplantation (P < 0.05). 4 Both groups showed weight loss, hair removal and other adverse reactions after transplantation. One mouse in the control group died of graft-versus-host disease on day 52 after transplantation, and the body weight gradually increased from day 15 after transplantation. No mice died during the observation period in the experimental group, and the body weight gradually increased from 35 days after transplantation. Conclusion The early infusion of donor immune cells after bone marrow transplantation can promote the implantation of donor bone marrow cells and improve the therapeutic effect, which deserves further study and may provide new ideas for the clinical treatment of leukemia.
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