青岛大学学报（医学版）2024，Vol.60Issue(2)：213-217,5.DOI:10.11712/jms.2096-5532.2024.60.038
allo-HSCT后淋巴细胞亚群重建与GVHD及感染的相关性
Association of lymphocyte subset reconstitution with graft-versus-host disease and infection after allogenic hematopoietic stem cell trans-plantation
摘要
Abstract
Objective To investigate the reconstitution of lymphocyte subsets in peripheral blood and the relationship be-tween lymphocyte subset changes and graft-versus-host disease(GVHD)and infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in patients with malignant hematologic diseases.Methods Thirty-two patients undergoing allo-HSCT were examined using flow cytometry for the distribution of lymphocyte subsets 3 d before myeloablative conditioning and 14,30,90,180,365,and 730 d after transplantation.The relationship between lymphocyte subset changes and GVHD and infection was analyzed.Results After transplantation,the reconstitution speed of total lymphocytes,CD3+T cells,CD4+T cells,CD8+T cells,CD16+CD56+NK cells,and CD19+B cells differed:NK cells recovered first to the pre-transplant level within 30 d;CD8+T cells around 30 d after transplantation;CD3+T cells around 60 d after transplantation;B lymphocytes around 360 d after transplantation;but CD4+T cells did not recover to the pre-transplant level 730 d after transplantation.On the 90th day after transplantation,5 patients had acute GVHD,whose absolute counts of CD3+T cells(t'=3.334,P＜0.05),CD4+T cells(t=3.836,P＜0.05),and CD16+CD56+NK cells(t=3.300,P＜0.05)were significantly lower compared with those without acute GVHD.On the 365th day after transplantation,17 patients had chronic GVHD,whose CD4+T cell count was significantly lower compared with those without chronic GVHD(t=2.918,P＜0.05).On the 180th day after transplantation,compared with the non-infection group(n=5),the viral infection group(n=6)showed significantly de-creased levels of lymphocytes(t=2.441,P＜0.05),CD4+T cells(t=3.513,P＜0.05),NK cells(t=3.728,P＜0.05),and B cells(t=2.937,P＜0.05);the bacterial infection group(n=8)showed significantly decreased levels of lymphocytes(t=2.535,P＜0.05)and CD4+T cells(t'=6.726,P＜0.05)and significantly increased levels of CD8+T cells(t'=-2.945,P＜0.05);the fungal infection group(n=4)showed significantly decreased CD4+T cell levels(t=2.579,P＜0.05)and significantly increased CD8+T cell levels(t=2.423,P＜0.05);the mixed infection group(n=9)showed significantly decreased absolute counts of lym-phocytes(t=2.195,P＜0.05),CD3+T cells(t=2.649,P＜0.05),CD4+T cells(t=3.728,P＜0.05),CD8+T cells(t=2.579,P＜0.05),B lymphocytes(t=3.045,P＜0.05),and NK cells(t=2.207,P＜0.05).Conclusion The reconstitution and chan-ges of lymphocyte subsets are related to the prognosis of patients after allo-HSCT,and lymphocyte subsets in peripheral blood should be continuously monitored before and after transplantation.关键词
造血干细胞移植/淋巴细胞亚群/移植物抗宿主病/感染Key words
hematopoietic stem cell transplantation/lymphocyte subsets/graft vs host disease/infections分类
医药卫生引用本文复制引用
王淑惠,慕莹,韩洁,魏晓芳,刘秋媛,阎丽平..allo-HSCT后淋巴细胞亚群重建与GVHD及感染的相关性[J].青岛大学学报（医学版）,2024,60(2):213-217,5.基金项目
山东省自然科学基金青年项目(ZR2022QH269) （ZR2022QH269）
