de Gast G C, Gratama J W, Verdonck L F, van Heugten J G, Zwaan F E, Phillips D I, Mudde G C
Department of Haematology, University Hospital Utrecht, The Netherlands.
Transplantation. 1989 Jul;48(1):111-5. doi: 10.1097/00007890-198907000-00026.
To test the influence of T cell depletion of the marrow in allogeneic bone marrow transplantation on functional T cell recovery, in vitro lymphocyte proliferation tests (LPTs) to microbial antigens were regularly performed in 23 recipients of normal BM and in 25 patients receiving BM with a fixed low number of T cells (1 x 10(5) T cells/kg body weight; recipients of T-depleted BM). The long-term recovery of positive LPT to at least 1 of the 4 tested microbial antigens--Candida, herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus--was nearly similar in both groups: 16/23 versus 18/25. Recovery of LPT to Candida and HSV in the first 3 months appeared to be greatly influenced by prophylactic measures; only 2/23 recipients of normal BM, receiving amphotericin B, showed a positive LPT to Candida versus 13/25 recipients of T-depleted BM (P less than 0.01). In contrast, only 1/23 seropositive recipients of T-depleted BM, receiving acyclovir, showed a positive LPT to HSV versus 9/22 recipients of normal BM (P less than 0.05). A positive LPT to CMV in the first 3 months was found in 9/9 seropositive recipients of normal BM, versus in 5/11 seropositive recipients of T-depleted BM (P less than 0.05). Five of the 6 patients with a negative LPT died of CMV-interstitial pneumonia versus 1/14 with positive LPT (P less than 0.01). We conclude that in CMV-seropositive recipients of allogeneic BM, T cell depletion of the graft affects the early recovery of T cell proliferation to CMV, which is associated with a higher risk of fatal CMV-interstitial pneumonia.
为了测试异基因骨髓移植中骨髓T细胞清除对功能性T细胞恢复的影响，对23例接受正常骨髓移植的受者和25例接受固定低数量T细胞（1×10⁵T细胞/千克体重；T细胞清除骨髓移植受者）的患者定期进行针对微生物抗原的体外淋巴细胞增殖试验（LPT）。两组中对4种测试微生物抗原（白色念珠菌、单纯疱疹病毒（HSV）、水痘-带状疱疹病毒（VZV）和巨细胞病毒）中至少1种抗原的LPT长期恢复情况几乎相似：16/23对比18/25。前3个月中对白色念珠菌和HSV的LPT恢复情况似乎受预防措施的极大影响；仅2/23接受两性霉素B的正常骨髓移植受者对白色念珠菌的LPT呈阳性，而T细胞清除骨髓移植受者中有13/25呈阳性（P<0.01）。相比之下，仅1/23接受阿昔洛韦的T细胞清除骨髓移植血清阳性受者对HSV的LPT呈阳性，而正常骨髓移植受者中有9/22呈阳性（P<0.05）。前3个月中，9/9血清阳性的正常骨髓移植受者对巨细胞病毒的LPT呈阳性，而T细胞清除骨髓移植血清阳性受者中有5/11呈阳性（P<0.05）。LPT阴性的6例患者中有5例死于巨细胞病毒性间质性肺炎，而LPT阳性的患者中1/14死亡（P<0.01）。我们得出结论，在异基因骨髓移植的巨细胞病毒血清阳性受者中，移植物的T细胞清除会影响T细胞对巨细胞病毒增殖的早期恢复，这与致命性巨细胞病毒性间质性肺炎的较高风险相关。
