Factors influencing lymphocyte reconstitution after allogeneic hematopoietic stem cell transplantation in children.

The Korean Journal of Hematology Pub Date : 2012-03-01 Epub Date: 2012-03-28 DOI:10.5045/kjh.2012.47.1.44
Keun Wook Bae, Bo Eun Kim, Kyung Nam Koh, Ho Joon Im, Jong Jin Seo
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引用次数: 24

Abstract

Background: Immune reconstitution (IR) after hematopoietic stem cell transplantation (HSCT) reduces transplantation-related complications such as infection and improves HSCT outcomes.

Methods: We retrospectively analyzed IR of lymphocyte subpopulations in 38 pediatric patients for hematologic malignant diseases after allogeneic HSCT from April 2006 to July 2008. T-cell-, B-cell-, and natural killer (NK) cell-associated antigens were assayed in peripheral blood by flow cytometry analysis of 5 lymphocyte subsets, CD3+, CD3+/CD4+, CD4+/CD8+, CD16+/CD56+, and CD19+, before and 3 and 12 months after transplantation.

Results: Reconstitutions of CD16+/CD56+ and CD3+/CD8+ lymphocytes were achieved rapidly, whereas that of CD3+/CD19+ lymphocytes occurred later. Age was not related to reconstitution of any lymphocyte subset. Total body irradiation (TBI) and anti-thymocyte globulin (ATG) administration were related to delayed reconstitution of total lymphocytes and CD3+ lymphocytes, respectively. Reconstitutions of CD3+/CD4+ lymphocytes and CD3+/CD8+ lymphocytes were significantly delayed in patients who received umbilical cord blood stem cells. In patients with chronic graft-versus-host disease (cGVHD), recovery of the total lymphocyte count and CD19+ lymphocytes at 3 months post-transplant were significantly delayed. However, acute GVHD (aGVHD) and cytomegalovirus (CMV) reactivation did not influence the IR of any lymphocyte subset. Further, delayed reconstitution of lymphocyte subsets did not correspond to inferior survival outcomes in this study.

Conclusion: We observed that some lymphocyte reconstitutions after HSCT were influenced by the stem cell source and preparative regimens. However, delayed CD19+ lymphocyte reconstitution may be associated with cGVHD.

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影响儿童异基因造血干细胞移植后淋巴细胞重建的因素。
背景:造血干细胞移植(HSCT)后的免疫重建(IR)减少了移植相关的并发症,如感染,并改善了HSCT的结果。方法:回顾性分析2006年4月至2008年7月38例小儿造血干细胞移植后血液恶性疾病患者淋巴细胞亚群IR。采用流式细胞术检测移植前、移植后3个月和12个月外周血中CD3+、CD3+/CD4+、CD4+/CD8+、CD16+/CD56+和CD19+ 5个淋巴细胞亚群的t细胞、b细胞和NK细胞相关抗原。结果:CD16+/CD56+和CD3+/CD8+淋巴细胞重建较快,CD3+/CD19+淋巴细胞重建较晚。年龄与任何淋巴细胞亚群的重建无关。全身照射(TBI)和抗胸腺细胞球蛋白(ATG)分别与总淋巴细胞和CD3+淋巴细胞的延迟重建有关。在接受脐带血干细胞治疗的患者中,CD3+/CD4+淋巴细胞和CD3+/CD8+淋巴细胞的重建明显延迟。慢性移植物抗宿主病(cGVHD)患者移植后3个月的总淋巴细胞计数和CD19+淋巴细胞恢复明显延迟。然而,急性GVHD (aGVHD)和巨细胞病毒(CMV)再激活不影响任何淋巴细胞亚群的IR。此外,在本研究中,淋巴细胞亚群的延迟重构并不对应于较差的生存结果。结论:我们观察到造血干细胞移植后的一些淋巴细胞重建受到干细胞来源和制备方案的影响。然而,CD19+淋巴细胞重构延迟可能与cGVHD有关。
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