Bae Keun Wook, Kim Bo Eun, Koh Kyung Nam, Im Ho Joon, Seo Jong Jin
Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Hematol. 2012 Mar;47(1):44-52. doi: 10.5045/kjh.2012.47.1.44. Epub 2012 Mar 28.
Immune reconstitution (IR) after hematopoietic stem cell transplantation (HSCT) reduces transplantation-related complications such as infection and improves HSCT outcomes.
We retrospectively analyzed IR of lymphocyte subpopulations in 38 pediatric patients for hematologic malignant diseases after allogeneic HSCT from April 2006 to July 2008. T-cell-, B-cell-, and natural killer (NK) cell-associated antigens were assayed in peripheral blood by flow cytometry analysis of 5 lymphocyte subsets, CD3+, CD3+/CD4+, CD4+/CD8+, CD16+/CD56+, and CD19+, before and 3 and 12 months after transplantation.
Reconstitutions of CD16+/CD56+ and CD3+/CD8+ lymphocytes were achieved rapidly, whereas that of CD3+/CD19+ lymphocytes occurred later. Age was not related to reconstitution of any lymphocyte subset. Total body irradiation (TBI) and anti-thymocyte globulin (ATG) administration were related to delayed reconstitution of total lymphocytes and CD3+ lymphocytes, respectively. Reconstitutions of CD3+/CD4+ lymphocytes and CD3+/CD8+ lymphocytes were significantly delayed in patients who received umbilical cord blood stem cells. In patients with chronic graft-versus-host disease (cGVHD), recovery of the total lymphocyte count and CD19+ lymphocytes at 3 months post-transplant were significantly delayed. However, acute GVHD (aGVHD) and cytomegalovirus (CMV) reactivation did not influence the IR of any lymphocyte subset. Further, delayed reconstitution of lymphocyte subsets did not correspond to inferior survival outcomes in this study.
We observed that some lymphocyte reconstitutions after HSCT were influenced by the stem cell source and preparative regimens. However, delayed CD19+ lymphocyte reconstitution may be associated with cGVHD.
造血干细胞移植（HSCT）后的免疫重建（IR）可减少感染等移植相关并发症，并改善HSCT结局。
我们回顾性分析了2006年4月至2008年7月间38例接受异基因HSCT治疗血液系统恶性疾病的儿科患者的淋巴细胞亚群免疫重建情况。通过流式细胞术分析移植前、移植后3个月和12个月外周血中5个淋巴细胞亚群（CD3+、CD3+/CD4+、CD4+/CD8+、CD16+/CD56+和CD19+）的T细胞、B细胞和自然杀伤（NK）细胞相关抗原。
CD16+/CD56+和CD3+/CD8+淋巴细胞的重建迅速，而CD3+/CD19+淋巴细胞的重建较晚。年龄与任何淋巴细胞亚群的重建均无关。全身照射（TBI）和抗胸腺细胞球蛋白（ATG）的使用分别与总淋巴细胞和CD3+淋巴细胞的重建延迟有关。接受脐带血干细胞的患者中，CD3+/CD4+淋巴细胞和CD3+/CD8+淋巴细胞的重建明显延迟。在患有慢性移植物抗宿主病（cGVHD）的患者中，移植后3个月总淋巴细胞计数和CD19+淋巴细胞的恢复明显延迟。然而，急性移植物抗宿主病（aGVHD）和巨细胞病毒（CMV）再激活并未影响任何淋巴细胞亚群的免疫重建。此外，在本研究中，淋巴细胞亚群的重建延迟与较差的生存结局无关。
我们观察到HSCT后某些淋巴细胞的重建受干细胞来源和预处理方案的影响。然而，CD19+淋巴细胞重建延迟可能与cGVHD有关。
