荧光原位杂交技术在异基因造血干细胞移植监测中的作用**

背景：异基因造血干细胞移植后,嵌合率下降与移植物被排斥及白血病复发密切相关,常规骨髓细胞学检查、染色体检查、流式细胞学检查等均不能敏感特异地监测嵌合率。 目的：验证荧光原位杂交技术检测异基因造血干细胞移植后嵌合率的敏感性和特异性。 方法：应用荧光原位杂交法检测异性同胞异基因造血干细胞移植后患者X、Y 性染色体及慢性粒细胞白血病序列特异性bcr/abl融合基因,以骨髓细胞学检查为对照。 结果与结论：3例异基因造血干细胞移植患者共复查骨髓细胞学检查及荧光原位杂交检查7次。4次骨髓细胞学检查及荧光原位杂交检查均完全相符,另外3次骨髓细胞学检查提示完全缓解,而荧光原位杂交检查能检测到少量异常信号,证实应用荧光原位杂交法较骨髓细胞学具有显著优越性,能动态敏感、特异地检测嵌合率。 关键词：荧光原位杂交;白血病;异基因;造血干细胞;细胞移植 doi:10.3969/j.issn.1673-8225.2012.06.021

Roles of fluorescence in situ hybridization in allogeneic hematopoietic stem cell transplantation

BACKGROUND: The chimeric rate is very important in the allogeneic hematopoietic stem cell transplantation. Its decline always means the host anti-graft or leukemia relapse. Many techniques, including bone marrow cytology, conventional cytogenetic and flow cytometry, are not sensitive and specific enough in monitoring the chimerism. OBJECTIVE: To verify the sensitivity and specificity of fluorescence in situ hybridization (FISH) in the detection of allogeneic chimerism after allogeneic hematopoietic stem cell transplantation. METHODS: The chimerism of the sex mismatched Allo-HSCT was detected by FISH, utilizing X, Y chromosomes and bcr/abl fusion gene, in comparison with bone marrow cytology. RESULTS AND CONCLUSION: Through monitoring the chimerism by FISH in 3 cases, which were sex mismatched Allo-HSCT, it is confirmed that FISH is more sensitive and specific than bone marrow cytology, and has the unique advantage in detection of chimerisms.