Immune reconstitution after allogeneic marrow transplantation compared with blood stem cell transplantation
Immune reconstitution after allogeneic marrow transplantation compared with blood stem cell transplantation
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DOI：
10.1182/blood.v97.11.3380
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发表时间：
2001-06-01
期刊：
影响因子：
20.3
通讯作者：
Boeckh, M
中科院分区：
文献类型：
--
作者：
Storek, J;Dawson, MA;Boeckh, M
异基因外周血干细胞移植含有的T和B细胞大约是骨髓移植的10倍。由于这些细胞可能会在移植受者体内存活很长时间，因此接受血液干细胞移植的受者可能比接受骨髓移植的受者免疫功能受损更少。对115名患者进行了免疫重建研究，这些患者被随机分配接受异基因骨髓移植或非格列汀动员的血液干细胞移植。在移植后第30天至365天，大多数淋巴细胞亚群的计数在血液干细胞接受者中较高。CD4T细胞的差异最为显著(CD45RA(高)CD4T细胞约高4倍，CD45RA(低/-)CD4T细胞约高2倍；P<；0.05)。在使用植物血凝素和疱疹病毒抗原刺激的增殖进行评估时，两组患者的T细胞似乎功能相同。两组患者血清免疫球蛋白中位数相近。骨髓移植后明确感染率是骨髓受者的1.7倍(P=.001)。骨髓移植后严重(需要住院治疗)的明确感染率是骨髓受者的2.4倍(P=0.002)，真菌感染的明确感染率差异最大，细菌感染居中，病毒感染最低。与真菌或细菌感染相关的死亡发生在9名骨髓接受者和无血液干细胞接受者的移植后第30天至365天之间(P=0.008)，结论是，接受血液干细胞移植的人淋巴细胞亚群数量较高，这似乎导致较少的感染。(美国血液学学会，2001；97：3380-3389)(C)2001。
Allogeneic peripheral blood stem cell grafts contain about 10 times more T and B cells than marrow grafts. Because these cells may survive in transplant recipients for a long time, recipients of blood stem cells may be less immunocompromised than recipients of marrow. immune reconstitution was studied in 115 patients randomly assigned to receive either allogeneic marrow or filgrastim-mobilized blood stem cell transplantation. Between day 30 and 365 after transplantation, counts of most lymphocyte subsets were higher in the blood stem cell recipients. The difference was most striking for CD4 T cells (about 4-fold higher counts for CD45RA(high) CD4T cells and about 2-fold higher counts for CD45RA(low/-)CD4 T cells; P < .05). On assessment using phytohemagglutinin and herpesvirus antigen-stimulated proliferation, T cells in the 2 groups of patients appeared equally functional. Median serum IgG levels were similar in the 2 groups. The rate of definite infections after engraftment was 1.7-fold higher in marrow recipients (P =.001). The rate of severe (inpatient treatment required) definite infections after engraftment was 2.4-fold higher in marrow recipients (P =.002), The difference in the rates of definite infections was greatest for fungal infections, intermediate for bacterial infections, and lowest for viral infections. Death associated with a fungal or bacterial infection occurred between day 30 and day 365 after transplantation in 9 marrow recipients and no blood stem cell recipients (P = .008), In conclusion, blood stem cell recipients have higher lymphocyte-subset counts and this appears to result in fewer infections.(Blood, 2001;97:3380-3389) (C) 2001 by The American Society of Hematology.