Post-transplant immune reconstitution after unrelated allogeneic stem cell transplant in patients with acute myeloid leukemia
Post-transplant immune reconstitution after unrelated allogeneic stem cell transplant in patients with acute myeloid leukemia
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DOI：
10.3109/10428194.2010.496015
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发表时间：
2010-08-01
影响因子：
2.6
通讯作者：
Bacher, Ulrike
中科院分区：
文献类型：
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作者：
Klyuchnikov, Evgeny;Asenova, Svetlana;Bacher, Ulrike
我们评估了 67 名中位年龄为 40 岁 (4-69) 的急性髓系白血病 (AML) 患者在减少 (n = 35) 或清髓 (n = 32) 预处理后进行异基因 SCT 后的免疫恢复情况。在+30、+90、+180、+270和+365天通过流式相关细胞分选确定以下淋巴细胞群：CD3+、CD3+CD4+、CD3+CD8+、CD3+CD4+/CD3+CD8+比率、CD3-CD56+和CD19+细胞。外周原始细胞计数 >5% 与 CD3+CD4+（+30 天）和 NK 细胞（+180 天；p = 0.02）数量较低相关。调节强度对免疫恢复动力学没有任何显着影响。 CD3+CD4+/CD3+CD8+比率（第+30天）和NK细胞计数（第+90天；p < 0.05）正常的患者比参数降低的患者有更好的生存率。移植后脓毒症/严重感染损害了 CD3+CD8+（第 +90 天；p = 0.015）和 CD 19+（第 +90 天；p = 0.02）恢复。 allo-SCT 后患者的复发与 CD 19+（第 +270 天）和 NK 细胞（第 +365 天）数量减少有关。急性 GvHD (II-IV) 伴有 CD 19+ 和 CD3+CD4+ 细胞减少。因此，对 AML 患者移植后免疫重建的评估可能会改善有关复发或 TRM 的风险分层，仍有待进一步探索。
We evaluated immune recovery in 67 patients with acute myeloid leukemia (AML) with a median age of 40 years (4-69) following allo-SCT after reduced (n = 35) or myeloablative (n = 32) conditioning. The following lymphocyte populations were determined on days +30, +90, +180, +270, and +365 by flow associated cell sorting: CD3+, CD3+CD4+, CD3+CD8+, CD3+CD4+/CD3+CD8+ ratio, CD3-CD56+, and CD19+ cells. Peripheral blast count >5% was related to lower number of CD3+CD4+ (day +30) and NK cells (day +180; p = 0.02). Intensity of conditioning did not have any significant impact on the kinetics of immune recovery. Patients with normal CD3+CD4+/CD3+CD8+ ratio (day +30) and NK cell count (day +90; p < 0.05) experienced better survival than those with decreased parameters. Post-transplant sepsis/severe infections impaired CD3+CD8+ (day +90; p = 0.015) and CD 19+ (day +90; p = 0.02) recovery. Relapse in patients following allo-SCT showed an association with decreased numbers of CD 19+ (day +270) and NK cells (day +365). Acute GvHD (II-IV) was accompanied by reduced CD 19+ and CD3+CD4+ cells. Thus, the evaluation of post-transplant immune reconstitution in patients with AML might improve risk stratification concerning either relapse or TRM and remains to be further explored.