Factors influencing lymphocyte reconstitution after allogeneic hematopoietic stem cell transplantation in children.
Factors influencing lymphocyte reconstitution after allogeneic hematopoietic stem cell transplantation in children.
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DOI：
10.5045/kjh.2012.47.1.44
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发表时间：
2012-03
期刊：
影响因子：
--
通讯作者：
Seo JJ
中科院分区：
文献类型：
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作者：
Bae KW;Kim BE;Koh KN;Im HJ;Seo JJ
造血干细胞移植（HSCT）后的免疫重建（IR）可减少移植相关并发症（如感染）并改善HSCT结局。我们回顾性分析了2006年4月至2008年7月38例恶性血液病患儿异基因造血干细胞移植后淋巴细胞亚群的免疫反应。在移植前和移植后3个月和12个月，通过流式细胞术分析5种淋巴细胞亚群（CD 3+、CD 3 +/CD 4+、CD 4 +/CD 8+、CD 16 +/CD 56+和CD 19+）来检测外周血中T细胞、B细胞和自然杀伤（NK）细胞相关抗原。CD 16 +/CD 56+和CD 3 +/CD 8+淋巴细胞的重建很快，而CD 3 +/CD 19+淋巴细胞的重建发生较晚。年龄与任何淋巴细胞亚群的重建无关。全身照射（TBI）和抗胸腺细胞球蛋白（ATG）管理有关的总淋巴细胞和CD 3+淋巴细胞的延迟重建。在接受脐带血干细胞的患者中，CD 3 +/CD 4+淋巴细胞和CD 3 +/CD 8+淋巴细胞的重建显著延迟。在慢性移植物抗宿主病（cGVHD）患者中，移植后3个月总淋巴细胞计数和CD 19+淋巴细胞的恢复显著延迟。然而，急性GVHD（aGVHD）和巨细胞病毒（CMV）再激活不影响任何淋巴细胞亚群的IR。此外，淋巴细胞亚群重建延迟并不对应于本研究中较差的生存结局。我们观察到HSCT后的一些淋巴细胞重建受到干细胞来源和准备方案的影响。然而，延迟的CD 19+淋巴细胞重建可能与cGVHD相关。
Immune reconstitution (IR) after hematopoietic stem cell transplantation (HSCT) reduces transplantation-related complications such as infection and improves HSCT outcomes. We retrospectively analyzed IR of lymphocyte subpopulations in 38 pediatric patients for hematologic malignant diseases after allogeneic HSCT from April 2006 to July 2008. T-cell-, B-cell-, and natural killer (NK) cell-associated antigens were assayed in peripheral blood by flow cytometry analysis of 5 lymphocyte subsets, CD3+, CD3+/CD4+, CD4+/CD8+, CD16+/CD56+, and CD19+, before and 3 and 12 months after transplantation. Reconstitutions of CD16+/CD56+ and CD3+/CD8+ lymphocytes were achieved rapidly, whereas that of CD3+/CD19+ lymphocytes occurred later. Age was not related to reconstitution of any lymphocyte subset. Total body irradiation (TBI) and anti-thymocyte globulin (ATG) administration were related to delayed reconstitution of total lymphocytes and CD3+ lymphocytes, respectively. Reconstitutions of CD3+/CD4+ lymphocytes and CD3+/CD8+ lymphocytes were significantly delayed in patients who received umbilical cord blood stem cells. In patients with chronic graft-versus-host disease (cGVHD), recovery of the total lymphocyte count and CD19+ lymphocytes at 3 months post-transplant were significantly delayed. However, acute GVHD (aGVHD) and cytomegalovirus (CMV) reactivation did not influence the IR of any lymphocyte subset. Further, delayed reconstitution of lymphocyte subsets did not correspond to inferior survival outcomes in this study. We observed that some lymphocyte reconstitutions after HSCT were influenced by the stem cell source and preparative regimens. However, delayed CD19+ lymphocyte reconstitution may be associated with cGVHD.