Przybylski Grzegorz K, Kreuzer Karl-A, Siegert Wolfgang, Schmidt Christian A
Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, Poznań, Poland.
J Appl Genet. 2007;48(4):397-404. doi: 10.1007/BF03195239.
Improper T-cell reconstitution with its consequences, graft-vs-host disease (GvHD) and outbreak of viral infections, is the major cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). To determine the factors affecting reconstitution of naive T-cells after non-myeloablative HSCT (NM-HSCT), the T-cell receptor excision circle (TREC) content was measured on a weekly basis in 24 transplanted patients with various malignant diseases. We analysed correlations of the results with the development of GvHD. In addition, in 11 chronic myeloid leukaemia (CML) patients, we correlated TREC and BCR-ABL transcript numbers. After HSCT, in most patients (22/24) TRECs became undetectable. In 12 patients, TRECs reappeared 3-4 months after HSCT, in 1 patient TRECs reappeared 5 months after HSCT, and in 11 patients TRECs remained negative for more than a year. All 11 patients who remained TREC-negative, developed acute GvHD grade 2-3, while only 6 out of 13 patients who recovered TRECs developed GvHD. We show that after non-myeloablative HSCT, thymopoiesis takes place and is affected by GvHD. Our results indicate that no recovery of TRECs after NM-HSCT (which most likely reflect the expansion of host-reactive co-transplanted mature T-cells) correlates with the onset of GvHD.
T细胞重建不当及其后果，即移植物抗宿主病（GvHD）和病毒感染爆发，是造血干细胞移植（HSCT）后发病和死亡的主要原因。为了确定影响非清髓性HSCT（NM-HSCT）后幼稚T细胞重建的因素，我们对24例患有各种恶性疾病的移植患者每周测量一次T细胞受体切除环（TREC）含量。我们分析了结果与GvHD发展的相关性。此外，在11例慢性粒细胞白血病（CML）患者中，我们将TREC与BCR-ABL转录本数量进行了关联分析。HSCT后，大多数患者（22/24）的TREC检测不到。12例患者在HSCT后3-4个月TREC重新出现，1例患者在HSCT后5个月TREC重新出现，11例患者TREC持续阴性超过一年。所有11例TREC持续阴性的患者均发生了2-3级急性GvHD，而13例TREC恢复的患者中只有6例发生了GvHD。我们表明，非清髓性HSCT后发生了胸腺生成，且受GvHD影响。我们的结果表明，NM-HSCT后TREC未恢复（这很可能反映了共移植的宿主反应性成熟T细胞的扩增）与GvHD的发生相关。
