Immune reconstitution and outcome after unrelated cord blood transplantation: a single paediatric institution experience
Immune reconstitution and outcome after unrelated cord blood transplantation: a single paediatric institution experience
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DOI：
10.1038/sj.bmt.1702089
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发表时间：
2000-01-01
影响因子：
4.8
通讯作者：
Michel, G
中科院分区：
文献类型：
--
作者：
Giraud, P;Thuret, I;Michel, G
我们报告了1997年2月至1998年7月期间在一家机构接受非亲缘脐带血移植（U-CBT）的12例儿童的结局。1年无事件生存率为67%（95% CI为26%）。4例患儿死亡，3例患儿死亡原因为感染并发症。在移植后第一年期间，通过测定8名无病存活患者的总淋巴细胞计数、B细胞、NK细胞和T细胞亚群来研究免疫重建。我们观察到，除严重cGVHD患者外，所有患者的CD 19（+）细胞数量在9个月时迅速恢复，均大于500/μ l，B细胞构成移植后6和9个月的主要淋巴细胞亚群，根据正常儿科范围，B细胞数量正常或升高。我们注意到在移植后6个月伊加和IgM以及9个月IgG的血清免疫球蛋白水平正常。CD 3（+）细胞计数，特别是CD 3（+）CD 8（+）T细胞亚群在移植后12个月保持抑制。无关CBT后6个月，8名患者中有7名的CD 3（+）CD 8（+）细胞/μ l低于100。CD 3（+）CD 4（+）细胞恢复受损较小，所有儿童在第一年内的中位数为5个月，CD 3（+）CD 4（+）细胞绝对计数均大于200/mu l。NK细胞的百分比在CBT后的前6个月内升高，但其绝对计数保持在正常范围内。
We report the outcome of 12 children who underwent unrelated cord blood transplant (U-CBT) in a single institution between February 1997 and July 1998. The 1 year event-free survival was 67% (95% CI of 26%). Four children died with infectious complication as cause of death in three cases. Immune reconstitution was studied during first year post transplant by assaying total lymphocyte counts, B cells, NK cells and T cell subsets in the eight disease-free surviving patients. We observed a prompt recovery of CD19(+) cell number which was greater than 500/mu l at 9 months for all patients except the one with severe cGVHD, B cells constituted the predominant lymphocyte subset at 6 and 9 months post transplant with normal or elevated B cell numbers according to normal paediatric range. We noted normal serum immunoglobulin levels at 6 months post transplant for IgA and IgM and at 9 months for IgG, The CD3(+) cell count and particularly the CD3(+)CD8(+) T cell subset remained depressed until 12 months post transplant, Six months after unrelated CBT, seven out of eight patients had less than 100 CD3(+)CD8(+) cells/mu l. CD3(+)CD4(+) cell recovery was less impaired with all children achieving an absolute count of CD3(+)CD4(+) cells greater than 200/mu l during the first year in a median of 5 months. The percentage of NK cells was elevated during the first 6 months after CBT but their absolute count remained within the normal range.