Martínez C, Urbano-Ispizua A, Rozman C, Marín P, Rovira M, Sierra J, Montfort N, Carreras E, Montserrat E
Hematology Department, Postgraduate School of Hematology Farreras-Valentí, Institut d'Investigacions Biomédiques August Pí i Sunyer, University of Barcelona, Spain.
Exp Hematol. 1999 Mar;27(3):561-8. doi: 10.1016/s0301-472x(98)00029-0.
We compared the kinetic recovery of lymphocytes and their subsets in two groups of patients submitted to allogeneic peripheral blood progenitor cell transplantation (allo-PBT): those receiving lymphocyte-depleted leukaphereses by positive selection of CD34+ cells (group 1, n = 18) and those receiving unmanipulated leukaphereses (group 2, n = 15). Patients were conditioned with cyclophosphamide (120 mg/kg) and fractioned total body irradiation (13 Gy, group 1; 12 Gy, group 2). The mean number (x 10(6)/kg) of CD34+ and CD3+ cells infused was 4.0 and 0.67, respectively, in group 1 patients, and 4.7 and 274, respectively, for group 2 patients. Graft-versus-host disease prophylaxis consisted of cyclosporin A + methylprednisolone for group 1 and cyclosporin A + methotrexate for group 2. Median follow-up was 7 months (range 2-8 months) for both groups. During the first 6 months post-transplant, CD4+ cell counts were lower in group 1 as compared with group 2 (p = 0.014, 0.010, 0.011, 0.0003, and 0.052 at 0.5, 1, 2, 3, and 6 months, respectively), whereas there was no difference at 8 months. The number of CD4+CD45RA+ cells was very low throughout the study in both groups, being lower in group 1 than in group 2, especially during the first 3 months post-transplant (p = 0.007 and 0.0006 at 1 and 3 months). Normal levels of CD8+ cells were reached by 1 month post-transplant in both groups. TCR gamma delta + cell counts were lower in group 1 than in group 2 during the first 4 months post-transplant (p = 0.001, 0.004, and 0.04 at 1, 3, and 4 months). A normal number of natural killer cells (CD3-CD56+) was achieved 1 month post-transplant in both groups. B lymphocytes (CD19+) showed low or undetectable counts throughout the first 4 months in both groups, achieving the normal range at 8 months. These results show that, during the first 6 months following allo-PBT with CD34+ selected grafts, the number of CD4+, CD4+CD45RA+, and TCR gamma delta + cells is significantly lower than after unmanipulated allo-PBT; these differences disappeared at 8 months. In contrast, there are no differences between transplant groups in the recovery of CD8+, CD19+, and natural killer cells.
我们比较了两组接受异基因外周血祖细胞移植（allo - PBT）患者淋巴细胞及其亚群的动力学恢复情况：一组是通过阳性选择CD34⁺细胞进行淋巴细胞清除的白细胞单采术（第1组，n = 18），另一组是接受未处理的白细胞单采术（第2组，n = 15）。患者均接受环磷酰胺（120 mg/kg）预处理及分次全身照射（第1组13 Gy，第2组12 Gy）。第1组患者输注的CD34⁺和CD3⁺细胞的平均数量（×10⁶/kg）分别为4.0和0.67，第2组患者分别为4.7和274。第1组移植物抗宿主病预防方案为环孢素A + 甲泼尼龙，第2组为环孢素A + 甲氨蝶呤。两组的中位随访时间均为7个月（范围2 - 8个月）。移植后的前6个月，第1组的CD4⁺细胞计数低于第2组（分别在0.5、1、2、3和6个月时，p值分别为0.014、0.010、0.011、0.0003和0.052），而在8个月时无差异。在整个研究过程中，两组CD4⁺CD45RA⁺细胞数量都非常低，第1组低于第2组，尤其是在移植后的前3个月（1个月和3个月时p值分别为0.007和0.0006）。两组在移植后1个月时CD8⁺细胞水平均恢复正常。移植后的前4个月，第1组的TCRγδ⁺细胞计数低于第2组（1个月、3个月和4个月时p值分别为0.001、0.004和0.04）。两组在移植后1个月时自然杀伤细胞（CD3⁻CD56⁺）数量均恢复正常。两组的B淋巴细胞（CD19⁺）在最初4个月内计数均较低或检测不到，在8个月时达到正常范围。这些结果表明，在采用CD34⁺选择移植物的allo - PBT后的前6个月，CD4⁺、CD4⁺CD45RA⁺和TCRγδ⁺细胞数量显著低于未处理的allo - PBT后；这些差异在8个月时消失。相比之下，移植组之间在CD8⁺、CD19⁺和自然杀伤细胞的恢复方面没有差异。
