Kim D H, Sohn S K, Won D I, Lee N Y, Suh J S, Lee K B
Department of Hematology/Oncology, Kyungpook National University Hospital, 50 Samduk 2-ga, Jung-Gu, Daegu 700-721, Korea.
Bone Marrow Transplant. 2006 Jun;37(12):1119-28. doi: 10.1038/sj.bmt.1705381. Epub 2006 May 8.
The current study evaluates the role of quantitative measurement of peripheral lymphocyte subsets, especially CD4+ helper T-cell recovery, in predicting transplant outcomes including overall survival (OS) and non-relapse mortality (NRM) after allogeneic stem cell transplantation. A total of 69 allogeneic recipients were included with following diagnoses: acute myeloid leukemia 42, acute lymphoblastic leukemia 5, chronic myeloid leukemia 15, non-Hodgkin's lymphoma 5 and high-risk myelodysplastic syndrome 2. The peripheral lymphocyte subset counts (CD3+ T cells, CD3+4+ helper T cells, CD3+8+ cytotoxic T cells, CD19+ B cells, and CD56+ natural killer cells) were measured at 3, 6 and 12 months. The CD4+ helper T-cell reconstitution at 3 months was strongly correlated with OS (P<0.0001), NRM (P=0.0007), and opportunistic infections (P=0.0108) at the cutoff value of 200 x 10(6)/l CD4(+) helper T cells. Rapid CD4+ helper T-cell recovery was also associated with a higher CD4+ helper T-cell transplant dose (P=0.006) and donor type (P<0.001). An early CD4+ helper T-cell recovery at 3 months correlated with a subsequent faster helper T-cell recovery until 12 months, yet not with B-cell recovery. In a multivariate analysis, rapid recovery of CD4+ helper T cells at 3 months was a favorable prognostic factor together with higher CD34+ cell transplant dose in terms of OS (P=0.001) and NRM (P=0.005).
本研究评估外周淋巴细胞亚群定量测量的作用，尤其是CD4 +辅助性T细胞恢复情况，以预测异基因干细胞移植后的移植结局，包括总生存期（OS）和无复发生存率（NRM）。共纳入69例异基因造血干细胞移植受者，诊断如下：急性髓系白血病42例、急性淋巴细胞白血病5例、慢性髓系白血病15例、非霍奇金淋巴瘤5例和高危骨髓增生异常综合征2例。在3个月、6个月和12个月时测量外周淋巴细胞亚群计数（CD3 + T细胞、CD3 + 4 +辅助性T细胞、CD3 + 8 +细胞毒性T细胞、CD19 + B细胞和CD56 +自然杀伤细胞）。当CD4 +辅助性T细胞临界值为200×10⁶/l时，3个月时的CD4 +辅助性T细胞重建与OS（P < 0.0001）、NRM（P = 0.0007）和机会性感染（P = 0.0108）密切相关。CD4 +辅助性T细胞的快速恢复也与较高的CD4 +辅助性T细胞移植剂量（P = 0.006）和供体类型（P < 0.001）相关。3个月时CD4 +辅助性T细胞的早期恢复与随后至12个月时辅助性T细胞的更快恢复相关，但与B细胞恢复无关。在多变量分析中，就OS（P = 0.001）和NRM（P = 0.005）而言，3个月时CD4 +辅助性T细胞的快速恢复与较高的CD34 +细胞移植剂量一样，是一个有利的预后因素。
