Zhu M X, Wan W L, Li H S, Wang J, Wang Y F, Hu K, Ke X Y
Department of Hematology, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Jun 18;48(3):515-22.
To search for differences in early immune reconstitution after allogenic or autologous hematopoietic stem cell transplantation (HSCT).
The peripheral blood (PB) from 31 adult patients undergoing allogenic HSCT (allo-HSCT, 15 patients) or autologous HSCT (auto-HSCT, 16 patients) for the treatment of hematological malignancies and from 20 related healthy controls (HC) from December 2011 to August 2014 was used to analyze the kinetic recovery of lymphocyte subsets by means of flow cytometry during 12 months after HSCT. The T cell receptor rearrangement excision circle (TREC) levels among CD3(+) T cells were measured in the patients and HC to evaluate the thymic-dependent T cell reconstitution.
The allo- and auto-HSCT recipients did not differ significantly in CD4(+) T cells, CD8 naive T cells, effecter memory T cells (TEM), CD4 central memory T cells (TCM), mid-activated T cells and dendritic cells (DC)during the follow-up (P>0.05). But they both differed significantly from HC (P<0.05). CD8(+) T cells and NK cells reconstructed rapidly. There was no significant difference in the numbers of B cells between the allo- and auto-HSCT groups from M1 to M3 (P>0.05). B cells in both the groups were lower than those in HC (P<0.05). The recovery of B cells in auto-HSCT group was faster than in allo-HSCT group at M6 and M12 (P<0.05). The frequencies of CD4 naive T cells and later activated T cells in allo-HSCT group were significantly higher than in auto-HSCT group at M6 and M12 (P<0.05). The frequencies of CD8 TCM in auto-HSCT group were significantly higher than in allo-HSCT group at M6 and M12 (P<0.05). The TREC levels were significantly lower than in both the groups compared with the age-matched HC during the follow-up (P<0.05). No significant difference was observed between allo-HSCT and auto-HSCT groups (P>0.05).
The differences of the nature and the speed of lymphocyte reconstitution observed between the two patents groups were minor. This leads us to conclude that in allografted patients, immune reconstitution and subpopulations of peripheral blood lymphocytes are probably not related to the allogenicity of the graft, but due to the impaired thymus functions and slow differentiation of T lymphocytes in thymus.
探寻异基因或自体造血干细胞移植（HSCT）后早期免疫重建的差异。
收集2011年12月至2014年8月期间31例接受异基因HSCT（allo - HSCT，15例患者）或自体HSCT（auto - HSCT，16例患者）治疗血液系统恶性肿瘤的成年患者以及20名相关健康对照（HC）的外周血（PB），通过流式细胞术分析HSCT后12个月内淋巴细胞亚群的动态恢复情况。检测患者和HC中CD3(+) T细胞内的T细胞受体重排切除环（TREC）水平，以评估胸腺依赖性T细胞重建情况。
随访期间，allo - HSCT和auto - HSCT受者在CD4(+) T细胞、CD8幼稚T细胞、效应记忆T细胞（TEM）、CD4中央记忆T细胞（TCM）、中度活化T细胞和树突状细胞（DC）方面无显著差异（P>0.05）。但二者均与HC存在显著差异（P<0.05）。CD8(+) T细胞和NK细胞重建迅速。allo - HSCT组和auto - HSCT组在M1至M3期间B细胞数量无显著差异（P>0.05）。两组的B细胞均低于HC组（P<0.05）。auto - HSCT组在M6和M12时B细胞的恢复速度快于allo - HSCT组（P<0.05）。allo - HSCT组在M6和M12时CD4幼稚T细胞和晚期活化T细胞的频率显著高于auto - HSCT组（P<0.05）。auto - HSCT组在M6和M12时CD8 TCM的频率显著高于allo - HSCT组（P<0.05）。随访期间，两组的TREC水平均显著低于年龄匹配的HC组（P<0.05）。allo - HSCT组和auto - HSCT组之间未观察到显著差异（P>0.05）。
两个患者组之间观察到的淋巴细胞重建性质和速度差异较小。这使我们得出结论，在接受同种异体移植的患者中，免疫重建和外周血淋巴细胞亚群可能与移植物的异基因性无关，而是由于胸腺功能受损以及胸腺中T淋巴细胞分化缓慢所致。
