Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Bone Marrow Transplant. 2017 Aug;52(8):1164-1170. doi: 10.1038/bmt.2017.58. Epub 2017 Apr 3.
Graft failure (GF) remains an obstacle to survival after allogeneic hematopoietic stem cell transplantation. However, differentiating GF from delayed engraftment (DE) can be difficult. Host CD8 lymphocytes have been reported to mediate graft rejection, but the impact of macrophages on DE or GF is yet to be clarified. Peri-engraftment bone marrow (BM) specimens of 32 adult patients with normal engraftment, DE or GF were retrospectively evaluated to identify the potential associations of CD163 macrophage and CD8 lymphocyte infiltration into BM. The macrophage or CD8 lymphocyte number/total nucleated cell number was defined as the Mac ratio and CD8 ratio, respectively. Both DE and GF groups had significantly higher Mac ratios at day 14 than the normal group (P<0.0001), but no significant difference was observed between the DE and GF groups (P=1.000). The CD8 ratio at day 14 was significantly higher in the GF than in the normal group (P=0.005), whereas the CD8 ratios of the DE and normal groups were similar (P=0.07). A high Mac ratio at day 14 was associated with a risk of DE or subsequent GF. Patients with increased CD8 ratio at day 14 had a further risk of GF. The Mac ratio and the CD8 ratio appear to be well suited for predicting engraftment status.
移植物失败（GF）仍然是异基因造血干细胞移植后存活的障碍。然而，区分 GF 与延迟植入（DE）可能具有挑战性。宿主 CD8 淋巴细胞已被报道介导移植物排斥反应，但巨噬细胞对 DE 或 GF 的影响尚未阐明。回顾性评估了 32 例成人正常植入、DE 或 GF 患者的植入前骨髓（BM）标本，以确定 CD163 巨噬细胞和 CD8 淋巴细胞浸润 BM 的潜在关联。巨噬细胞或 CD8 淋巴细胞数量/总核细胞数量分别定义为 Mac 比和 CD8 比。DE 和 GF 组在第 14 天的 Mac 比均显著高于正常组（P<0.0001），但 DE 和 GF 组之间无显著差异（P=1.000）。GF 组第 14 天的 CD8 比明显高于正常组（P=0.005），而 DE 组和正常组的 CD8 比相似（P=0.07）。第 14 天高 Mac 比与 DE 或随后 GF 的风险相关。第 14 天 CD8 比增加的患者发生 GF 的风险进一步增加。Mac 比和 CD8 比似乎非常适合预测植入状态。
