Wu Ji-Ying, Huang Xiao-Jun
Institute of Hematology and People Hospital, Peking University, Beijing 100044, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2007 Apr;15(2):342-7.
To investigate the characteristics and significance of reconstitution of peripheral blood plasmacytoid dendritic cell (PDC) precursors after allogeneic human leukocyte antigen mismatched/haploidentical hematopoietic stem cell transplantation, and its relationship with chronic graft versus host disease (cGVHD) and relapse, 19 patients with leukemia were enrolled for this study. Peripheral blood dendritic cell (DC) subsets of patients and healthy controls were detected by flow cytometry, and the correlations between reconstitution of DC and cGVHD, relapse were analyzed. The results showed that compared with healthy subjects, patients with leukemia had a significantly decreased proportion and absolute number of myeloid dendritic cell (MDC), MDC1, DC and the ratio of MDC/PDC (P<0.05). There were not statistically different in MDC2 and PDC between patients and healthy subjects. After transplant, all the proportion of WBC and absolute numbers of DC reached to healthy controls levels at 9 months (P>0.05), besides the proportion of PDC which reached to healthy controls levels at 1 year (P=0.494). Compared with levels before relapse, the proportions of MDC1, MDC, DC and the ratio of MDC/PDC were lower, but proportions of MDC2 and PDC were slightly higher after relapse. Patients with a 'high' PDC recovery profile had an improved cumulative incidence of cGVHD in contrast to patients with a 'low' PDC recovery profile on day 120 after transplantation (P=0.007). It is concluded that compared with healthy subjects, de novo leukemia patients have a significantly decreased proportion and absolute number of DC and the ratio of MDC/PDC before haploidentical hematopoietic stem cell transplantation; while ratio of MDC/PDC can be normalized with relative rapidity, the proportions of all DC subsets reached to normal levels on the whole at 9 months after transplantation, and also recovery level of DCs is correlated with occurrence of cGVHD and relapse.
为探讨异基因人类白细胞抗原不相合/单倍型造血干细胞移植后外周血浆细胞样树突状细胞（pDC）前体细胞重建的特点及意义，及其与慢性移植物抗宿主病（cGVHD）和复发的关系，本研究纳入19例白血病患者。采用流式细胞术检测患者及健康对照者外周血树突状细胞（DC）亚群，并分析DC重建与cGVHD、复发的相关性。结果显示，与健康受试者相比，白血病患者髓样树突状细胞（MDC）、MDC1、DC的比例及绝对数量以及MDC/PDC比值均显著降低（P<0.05）。患者与健康受试者之间MDC2和pDC无统计学差异。移植后，除pDC比例在1年时达到健康对照水平（P=0.494）外，9个月时所有白细胞比例及DC绝对数量均达到健康对照水平（P>0.05）。与复发前水平相比，复发后MDC1、MDC、DC的比例及MDC/PDC比值降低，但MDC2和pDC比例略有升高。移植后120天，“高”pDC恢复型患者的cGVHD累积发生率低于“低”pDC恢复型患者（P=0.007）。结论：与健康受试者相比，初发白血病患者在单倍型造血干细胞移植前DC的比例、绝对数量及MDC/PDC比值显著降低；虽然MDC/PDC比值可较快恢复正常，但移植后9个月时所有DC亚群比例总体上均达到正常水平，且DC的恢复水平与cGVHD的发生及复发相关。
