Fujimaki K, Maruta A, Yoshida M, Kodama F, Matsuzaki M, Fujisawa S, Kanamori H, Ishigatsubo Y
Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
Bone Marrow Transplant. 2001 Jun;27(12):1275-81. doi: 10.1038/sj.bmt.1703056.
Immune reconstitution is an important component of successful allogeneic bone marrow transplantation. Immune reconstitution was evaluated for 5 years after transplantation. While the number of CD8+ T cells and CD56+ cells recovered early post transplantation, a low number of CD4+ and CD4+ CD45RA+ T cells and reversal of the CD4/CD8 ratio continued up to 5 years. Although early recovery of IgG and IgM was seen at day 100 post transplantation, serum concentration of IgA was below the normal range at 6 months and increased gradually up to 5 years. Development of acute GVHD did not affect the numbers of CD4+, CD8+, CD4+ CD45RA+ and CD4+ CD29+ T cells, but the number of CD56+ cells in patients who developed grades II-IV acute GVHD was low. The number of CD4+ CD29+ T cells had a tendency to be higher in the patients with extensive chronic GVHD than in those without chronic GVHD 2 years after transplantation whereas the number of CD4+ CD45RA+ T cells was low in spite of the absence of chronic GVHD. Serum concentration of IgA was lower in patients with extensive chronic GVHD than in those without chronic GVHD at 180 days. The number of CD4+ CD45RA+ cells in 10-19-year-old patients was higher than that in 40-49-year-old patients. Response to the Con A and PHA in 10-19-year-old patients was higher than that in older patients at 1 and 2 years. There was no significant difference in the ability of immune reconstitution between related transplant recipients and unrelated transplant recipients. These results suggest that chronic GVHD and age of patients affected immune reconstitution post transplant.
免疫重建是异基因骨髓移植成功的重要组成部分。对移植后5年的免疫重建情况进行了评估。虽然移植后早期CD8⁺T细胞和CD56⁺细胞数量有所恢复，但CD4⁺和CD4⁺CD45RA⁺T细胞数量较低，且CD4/CD8比值的逆转持续了5年。尽管移植后第100天IgG和IgM出现早期恢复，但IgA血清浓度在6个月时低于正常范围，并逐渐上升至5年。急性移植物抗宿主病（GVHD）的发生并未影响CD4⁺、CD8⁺、CD4⁺CD45RA⁺和CD4⁺CD29⁺T细胞的数量，但发生II-IV级急性GVHD的患者中CD56⁺细胞数量较低。移植2年后，广泛慢性GVHD患者的CD4⁺CD29⁺T细胞数量有高于无慢性GVHD患者的趋势，而尽管没有慢性GVHD，CD4⁺CD45RA⁺T细胞数量仍较低。180天时，广泛慢性GVHD患者的IgA血清浓度低于无慢性GVHD患者。10-19岁患者的CD4⁺CD45RA⁺细胞数量高于40-49岁患者。10-19岁患者在1年和2年时对刀豆蛋白A和植物血凝素的反应高于老年患者。相关移植受者和无关移植受者之间的免疫重建能力没有显著差异。这些结果表明，慢性GVHD和患者年龄影响移植后的免疫重建。
