Heining C, Spyridonidis A, Bernhardt E, Schulte-Mönting J, Behringer D, Grüllich C, Jakob A, Bertz H, Finke J
Department of Hematology/Oncology, University of Freiburg, Hugstetterstrasse 55, Freiburg 79106, Germany.
Bone Marrow Transplant. 2007 May;39(10):613-22. doi: 10.1038/sj.bmt.1705648. Epub 2007 Mar 26.
Here we investigated the influence of parameters known before hematopoietic stem cell transplantation (HSCT) as well as the relevance of graft-versus-host disease (GvHD) and cytomegalovirus (CMV) reactivation on post transplant lymphocyte reconstitution in 148 patients treated in our institution between 1996 and 2003. Median patient age was 42 (19-68) years, HSCT followed standard high dose (n=91) or reduced-intensity conditioning regimens (n=57) with bone marrow (BM, n=67) or peripheral blood stem cells (PBSC, n=81) from related (n=71) or unrelated (n=77) donors. In the first months, we observed a partially faster reconstitution of CD3+4+, CD3+8+ and CD4+45RA+ T cells in patients following peripheral blood stem cell transplantation when compared to bone marrow transplantation. Prolonged CD3+4+ and CD4+45RA+ lymphopenia was noted after unrelated donor HSCT and GvHD prophylaxis containing anti-T-lymphocyte globulin. Lymphocyte subset counts in patients older than the median age were comparable to those in patients transplanted at a younger age and not influenced by the conditioning regimen. CD3+8+ T cell reconstitution was strongly correlated with CMV reactivation, but not significantly affected by CMV serostatus before HSCT. Incidence or extent of GvHD did not significantly influence lymphocyte reconstitution. Therefore, the source of graft is the most predictive parameter in early lymphocyte reconstitution, but the differences in lymphocyte recovery completely resolved within the first year after HSCT.
在此，我们研究了1996年至2003年间在我们机构接受治疗的148例患者中，造血干细胞移植（HSCT）前已知参数的影响，以及移植物抗宿主病（GvHD）和巨细胞病毒（CMV）重新激活对移植后淋巴细胞重建的相关性。患者中位年龄为42（19 - 68）岁，HSCT采用标准大剂量（n = 91）或减低强度预处理方案（n = 57），使用来自相关（n = 71）或无关（n = 77）供者的骨髓（BM，n = 67）或外周血干细胞（PBSC，n = 81）。在最初几个月，我们观察到与骨髓移植相比，接受外周血干细胞移植的患者中CD3 + 4 +、CD3 + 8 +和CD4 + 45RA + T细胞的重建部分更快。在无关供者HSCT和含有抗T淋巴细胞球蛋白的GvHD预防后，观察到CD3 + 4 +和CD4 + 45RA +淋巴细胞减少持续存在。年龄大于中位年龄的患者淋巴细胞亚群计数与较年轻患者的计数相当，且不受预处理方案影响。CD3 + 8 + T细胞重建与CMV重新激活密切相关，但不受HSCT前CMV血清学状态的显著影响。GvHD的发生率或程度对淋巴细胞重建无显著影响。因此，移植物来源是早期淋巴细胞重建中最具预测性的参数，但淋巴细胞恢复的差异在HSCT后第一年内完全消失。
