骨髓增生异常综合征患者骨髓异常克隆细胞起源的初步研究

摘要

本研究旨在探讨骨髓增生异常综合征(MDS)患者骨髓异常克隆细胞的起源,即MDS患者骨髓CD34+ CD38-造血千细胞和CD34+ CD38+祖细胞中是否存在恶性克隆细胞及其比例.用免疫磁珠分选技术(MACS)分选9例染色体异常的MDS患者(8三体4例,含有8三体的复杂核型1例,5q(-2)例,含有5q-的复杂核型1例,5q-并8三体1例)的骨髓单个核细胞(BMMNC)中的CD34+ CD38-细胞和CD34+ CD38+细胞,分别涂片;然后在上述涂片上通过荧光原位杂交(FISH)方法比较CD34+ CD38-和CD34+ CD38+两群细胞中异常克隆细胞的百分比.结果发现,这两群细胞均有异常克隆累及,但CD34+ CD38-干细胞中异常克隆的比例(41.8 ±8.4)%低于CD34+ CD38+祖细胞(72.4±7.7)%(p<0.001),而在有核细胞检测的异常克隆细胞比例为(70.8 ±9.2)%.结论:提示MDS患者中5q-和+8异常克隆均可能起源于造血干细胞阶段,而在祖细胞阶段异常克隆占优势.%The study was aimed to investigate the origination of abnormal clones in hematopoietic cells of MDS patients. That is to say if there are abnormal clones in CD34 + CD38 - and CD34 + CD38 + cells and their proportions in MDS patients. Immuno-magnetic bead technique was used to sort CD34 + CD38 - and CD34+ CD38+ in bone marrow mononuclear cells of 9 MDS patients with chromosome abnormalities ( four cases with trisomy 8, 1 case with trisomy 8 complex karyotype, 2 cases with 5q-, 1 case with 5q- complex karyotype, 1 case with 5q- accompanying trisomy 8)and smears were made respectively. Then the percentage of abnormal clones in CD34+ CD38 - and CD34 + CD38 + cells were compared by using FISH. The results indicated that abnormal clones were involved in the two population cells in 9 patients. The percentage of abnormal clones in CD34 + CD38 - cells (41.8 ± 8.4％ ) was obviously lower than that in CD34 + CD38 + cells ( 72.4 ± 7.7 ％ ) (p ＜ 0. 001 ), and the percentage of abnormal clones in karyocytes was 70. 8 ±9. 2％. It is concluded the abnormal clones of bone marrow hematopoietic cells may originate from stem cell stage in MDS patients with 5q- and + 8, and the abnormal clones are predominant at stage of progenitors.