Center for Allogeneic Stem Cell Transplantation, B87, Karolinska University Hospital, SE-141 86 Stockholm, Sweden.
Clin Immunol. 2012 Mar;142(3):343-50. doi: 10.1016/j.clim.2011.12.001. Epub 2011 Dec 16.
T-cell deficiency after allogeneic stem cell transplantation (ASCT) is common and has major impact on clinical outcome. In this retrospective study 210 patients were analyzed with regards to levels of T-cell receptor excision circles (TRECs) during the first 24 months after transplantation. We could for the first time show a significant correlation between the use of bone marrow grafts and higher TREC levels >6 months post-ASCT (p<0.001). Treatment with anti-thymocyte globulin was correlated with lower TREC levels ≤6 months post-ASCT (p<0.001). Patients with TREC levels above median at 3 months had a superior overall survival, 80% vs. 56% (p=0.002), and lower transplantation-related mortality, 7% vs. 21% (p=0.01). We conclude that graft source and conditioning regimen may have a significant effect on T-cell reconstitution after ASCT and can thus affect outcome. These results strongly support the use of TREC measurement as part of the standard repertoire of immunological monitoring after ASCT.
异基因造血干细胞移植（ASCT）后 T 细胞缺陷很常见，对临床结果有重大影响。在这项回顾性研究中，分析了 210 例患者在移植后 24 个月内 T 细胞受体切除环（TREC）的水平。我们首次表明，骨髓移植物的使用与移植后 6 个月以上的更高 TREC 水平（p<0.001）之间存在显著相关性。抗胸腺细胞球蛋白治疗与移植后≤6 个月的更低 TREC 水平相关（p<0.001）。3 个月时 TREC 水平高于中位数的患者总生存率更高，80% vs. 56%（p=0.002），移植相关死亡率更低，7% vs. 21%（p=0.01）。我们得出结论，移植物来源和预处理方案可能对 ASCT 后 T 细胞重建有显著影响，从而影响结果。这些结果有力支持将 TREC 测量作为 ASCT 后免疫监测标准谱的一部分。
