Immune recovery after in vivo T-cell depletion myeloablative conditioning hematopoietic stem cell transplantation in severe beta-thalassemia children
Immune recovery after in vivo T-cell depletion myeloablative conditioning hematopoietic stem cell transplantation in severe beta-thalassemia children
复制标题
严重β地中海贫血儿童体内T细胞耗竭清髓调理造血干细胞移植后的免疫恢复。
DOI：
10.1111/ejh.13289
复制
发表时间：
2019-08-06
影响因子：
3.1
通讯作者：
Lai, Yong-Rong
中科院分区：
文献类型：
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作者：
Qin, Fang;Shi, Lingling;Lai, Yong-Rong
研究背景重型β-地中海贫血（β-TM）患者造血干细胞移植（HSCT）的临床结局与移植后免疫重建（IR）密切相关。然而，在这些环境中的IR数据是稀缺的。方法前瞻性分析47例重度β-TM患儿接受体内T细胞清除清髓性预处理和同胞供者HSCT后的临床结局和IR。测定了免疫重建，包括免疫细胞亚群计数，以及HSCT后新T和B细胞测定的产生。结果HSCT后1年内细菌感染率为70.2%，巨细胞病毒（CMV）再激活率为36.2%。在同一时期，观察到CD 4（+）T细胞恢复较差。B细胞在6个月内恢复。自然杀伤（NK）细胞恢复早在1个月，但他们的功能是有缺陷的。脐血骨髓（CB + BM）组与外周血骨髓（PB + BM）组相比，T细胞恢复较慢，而B细胞和NK细胞水平较高。结论重度β-TM患者行体内T细胞去除清髓性预处理HSCT后1年内感染发生率高与IR差一致。
Background The clinical outcome of hematopoietic stem cell transplantation (HSCT) in those with severe beta-thalassemia (beta-TM) is closely related to post-transplantation immune reconstitution (IR). However, the data on the IR in these settings are scarce. Methods A prospective analysis of the clinical outcome and IR in 47 children with severe beta-TM who underwent in vivo T-cell depletion myeloablative conditioning and matched sibling donor HSCT was performed. Immune reconstitution, including immune cell subset counts, as well as the generation of new T and B cells assays after HSCT, was measured. Results In the first year after HSCT, bacterial infections and cytomegalovirus (CMV) reactivation were observed in 70.2% and 36.2% of the patients, respectively. In the same period, poor CD4(+) T-cell recovery was observed. The B cells recovered within 6 months. Natural killer (NK) cells recovered as early as 1 month, but their function was defective. Cord blood and bone marrow (CB + BM) group had slower T-cell recovery, and higher B cells and NK cells in comparison with peripheral blood and bone marrow (PB + BM) group. Conclusions The high incidence of infection within 1 year after in vivo T-cell depletion myeloablative conditioning HSCT in severe beta-TM was consistent with poor IR.