Clinical impact of early absolute lymphocyte count after allogeneic stem cell transplantation
Clinical impact of early absolute lymphocyte count after allogeneic stem cell transplantation
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DOI：
10.1111/j.1365-2141.2004.04891.x
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发表时间：
2004-04-01
影响因子：
6.5
通讯作者：
Lee, KB
中科院分区：
文献类型：
--
作者：
Kim, DH;Kim, JG;Lee, KB
异基因干细胞移植（SCT）后淋巴细胞再生的作用包括预防严重感染和在移植后早期攻击残留的肿瘤细胞。因此，本研究分析了SCT后第21天的绝对淋巴细胞计数（ALC）在预测82例患者的移植结局中的作用，包括机会性感染和原发病复发的风险。输注的CD 34（+）、CD 3（+）和单核细胞（MNC）的中位剂量分别为6.41 x 10（6）/kg、1.96 x 10（8）/kg和6.81 x 10（8）/kg。高ALC组（第21天高ALC;大于或等于0.35 × 10（9）/l）与使用外周血干细胞、匹配的同胞供体和较高的MNC CD 3（+）和CD 4（+）细胞剂量有关。高ALC组3年后的总生存率（56.3% vs. 17.7%）和无病生存率（50.1% vs. 15.9%）也更好，1年后复发率（33.6% vs. 67.1%）和真菌感染率（3.0% vs. 19.5%）更低。高ALC组中巨细胞病毒抗原血症的发生率较低（47.7% vs. 73.7%）。因此，在第21天鉴定ALC似乎是预测那些具有高风险的机会性感染和同种异体SCT后复发的患者的有用且简单的测量。
The role of repopulating lymphocytes after allogeneic stem cell transplantation (SCT) includes the prevention of serious infections and attacking residual tumour cells in the early post-transplant phase. Therefore, the current study analysed the role of the absolute lymphocyte count (ALC) on day 21 after SCT in predicting transplant outcomes of 82 patients in terms of the risk of opportunistic infections and recurrence of original disease. The median dose of CD34(+), CD3(+) and mononuclear cells (MNC) infused was 6.41 x 10(6)/kg, 1.96 x 10(8)/kg and 6.81 x 10(8)/kg respectively. The high ALC group (high ALC on day 21; greater than or equal to0.35 x 10(9)/l) was associated with the use of peripheral blood stem cells, matched sibling donors and higher cell doses of MNC CD3(+) and CD4(+) cells. The high ALC group also exhibited a better overall survival (56.3% vs. 17.7%) and disease-free survival (50.1% vs. 15.9%) after 3 years and lower incidences of relapse (33.6% vs. 67.1%) and fungal infections (3.0% vs. 19.5%) after 1 year. The incidence of cytomegalovirus antigenaemia was lower in the high ALC group (47.7% vs. 73.7%). Accordingly, identifying the ALC on day 21 would appear to be a useful and simple measurement to predict those patients with a high risk of opportunistic infections and relapse after allogeneic SCT.