肾移植受者多克隆抗T淋巴细胞抗体治疗监测：CD3 + T细胞与总淋巴细胞计数的比较
Polyclonal anti T-lymphocyte antibody therapy monitoring in kidney transplant recipients: comparison of CD3+ T cell and total lymphocyte counts.
作者信息
Machado Fabiani Palagi, Vicari Alessandra Rosa, Spuldaro Fábio, Castro Filho João Batista Saldanha de, Manfro Roberto Ceratti
机构信息
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
出版信息
Einstein (Sao Paulo). 2018 Nov 29;16(4):eAO4278. doi: 10.31744/einstein_journal/2018AO4278.
OBJECTIVE
To investigate the correlation between total lymphocyte and CD3+ T cell counts in peripheral blood in renal transplant patients treated with anti-thymocyte globulin, and discuss related outcomes.
METHODS
A single-center, retrospective study involving 226 patients submitted to kidney transplant between 2008 and 2013, and treated with anti-thymocyte globulin for induction or treatment of cellular rejection. Doses were adjusted according to CD3+ T cell or total lymphocyte counts in peripheral blood.
RESULTS
A total of 664 paired samples were analyzed. The Spearman's correlation coefficient was 0.416 (p<0.001) for all samples combined; the overall Kappa coefficient was 0.267 (p<0.001). Diagnostic parameters estimated based on total lymphocyte counts were also calculated using the number of CD3+ T cells (gold standard), with a cut off of >20 cells/mm3.
CONCLUSION
Total lymphocyte and CD3+ T cell counts in peripheral blood are not equivalent monitoring strategies in anti-thymocyte globulin therapy.
目的
探讨接受抗胸腺细胞球蛋白治疗的肾移植患者外周血中总淋巴细胞计数与CD3⁺ T细胞计数之间的相关性，并讨论相关结果。
方法
一项单中心回顾性研究，纳入了2008年至2013年间接受肾移植且接受抗胸腺细胞球蛋白诱导或治疗细胞排斥反应的226例患者。根据外周血中CD3⁺ T细胞或总淋巴细胞计数调整剂量。
结果
共分析了664对样本。所有样本合并后的Spearman相关系数为0.416（p<0.001）；总体Kappa系数为0.267（p<0.001）。还使用CD3⁺ T细胞数量（金标准）计算了基于总淋巴细胞计数估计的诊断参数，截断值为>20个细胞/mm³。
结论
在外周血中，总淋巴细胞计数与CD3⁺ T细胞计数并非抗胸腺细胞球蛋白治疗中等效的监测策略。
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