CELL INTELLIGENCE · 肿瘤细胞治疗研究

OBJECTIVE: In minimal residual disease (MRD) analysis after allogeneic hematopoietic stem cell transplantation (allo-HSCT), abnormal immunophenotyping is commonly considered as evidence of a secondary recurrence or complications, leading to overtreatment. We aimed to confirm whether such phenotypic abnormality might originate from donors using multicolor flow cytometry (MFC). MATERIALS AND METHODS: The MRD of bone marrow specimens of 3395 patients who had received allo-HSCT were analyzed using the conventional two-tube, eight-color MFC panel. The frequencies of abnormal immunophenotypes were also evaluated in three groups of patients without malignancies. RESULTS: The frequency of new abnormal polymorphisms was 0.088% (3/3395) among patients who received allo-HSCT. The abnormal cells seen in three patients in complete remission were Fc receptor IIIB (Fc RIIIB) gene deletion (CD16- neutrophils), CD2-CD159a-CD159c + natural killer (NK) cells, and monoclonal B lymphocytosis (MBL), respectively. In addition, abnormal T-cells (CD4 + CD8 + ) were detected in one donor before allo-HSCT. Identical abnormalities were found in the peripheral blood of the corresponding donors of the three patients via MFC. Among the individuals without malignancies, the incidence of Fc RIIIB deletion was 0.2% (11/5256), that of NK cells with the absence of CD2 and single-positive CD159c was 0.05% (1/2000), that of monoclonal CD4/CD8 double-positive T-cells was 0.05% (1/2000), and that of MBL was 1.3% (14/1100). The frequency of NK cells with the absence of CD2 was 1.3% (1/79) and with CD8 dim was 14% (11/79) in NK cell lymphoma. The following abnormalities could be identified by the two-tube, eight-color MFC panel: c /c /CD19/CD5/CD20/ CD38/CD45/CD56 (adding CD10 and CD34 as the ninth and tenth colors) and CD16 + CD56/CD5/CD3/CD7/CD4/CD8/CD2/CD45 (adding CD117 as the ninth color). CONCLUSION: Abnormalities in recipients of allo-HSCT detected by MRD analysis may originate from their donors. Screening of donor specimens with a suitable two-tube, eight- to ten-color MFC panel may be a promising method for minimizing misdiagnoses. AMAÇ: Allojeneik hematopoetik k k h cre nakli (allo-KHN) sonras minimal kal nt hastal k (MKH) analizinde anormal imm nofenotiplendirme s kl kla sekonder rek rrensin ya da komplikasyonlar n kan t d r, neticede fazla tedaviye yol a ar. Bu tarz fenotipik anormalliklerin ok renkli ak m sitometri (ASM) kullanarak verici k kenli olabilece ini g stermek ve bunu do rulamay hedefledik. GEREÇ VE YÖNTEMLER: Allo-KHN olmu 3395 hastan n kemik ili i rneklerinde konvansiyonel iki t p sekiz renkli ASM paneli ile MKH bak ld . Anormal imm nfenotiplenmenin s kl klar da malignitesi olmayan grup hastada de erlendirildi. BULGULAR: Allo-KHN olan hastalarda yeni anormal polimorfizmlerin s kl %0,088 (3/3395) idi. Tam remisyondaki hastada mevcut anormal h creler s ras yla Fc resept r IIIB (Fc RIIIB) gen delesyonu (CD16 n trofil), CD2CD159aCD159c do al ld r c (NK) h creleri ve monoclonal B lenfositoz (MBL) idi. Ilaveten, bir vericide allo-KHN ncesinde anormal T-h creleri (CD4CD8) tespit edilmi ti. Benzer anormallikler hastan n vericilerinin periferik kanlar nda ASM ile bulunmu tur. Malignitesi olmayan bireylerde Fc RIIIB delesyonu insidans %0,2 (11/5256), CD2 si olmayan NK h creleri ve tek CD159c pozitif olanlar %0,05 (1/2000), monoclonal CD4/CD8 ift pozitif T-h creleri %0,05 (1/2000), MBL %1,3 (14/1100) bulundu. NK h creli lenfomada CD2 negatif NK h creleri s kl %1,3 (1/79) ve CD8 dim olanlar %14 (11/79) idi. S radaki anormallikler ift t p sekiz renkli ASM paneli ile tan mlanm t r: c /c /CD19/CD5/CD20/CD38/CD45/CD56 (CD10 ve CD34 dokuzuncu ve onuncu renk olarak eklenmi tir) ve CD16 + CD56/CD5/CD3/CD7/CD4/CD8/CD2/CD45(CD117 dokuzuncu renk olarak eklenmi tir). SONUÇ: Allo-KHN al c lar nda MKH ile tespit edilen anormallikler vericilerinden kaynaklanabilir. Verici rneklerinin ift t p sekiz-on renkli ASM paneli ile taranmas yanl tan lar en az