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异基因造血干细胞移植后早期血清游离轻链水平对慢性移植物抗宿主病的预测价值:一项初步研究

The predictive value of serum free light chain level early after allogeneic hematopoietic stem cell transplantation for chronic graft-versus-host disease, a preliminary study.

作者信息

Wang Bingjie, Liang Zeyin, Liu Wei, Sun Yuhua, Cen Xi'nan, Dong Yujun, Ren Hanyun

机构信息

Department of Hematology, Peking University First Hospital, Beijing, China.

出版信息

Clin Transplant. 2020 Jul;34(7):e13865. doi: 10.1111/ctr.13865. Epub 2020 May 13.

Abstract

OBJECTIVE

Serum free light chain (FLC) level is closely associated with the functional state of B lymphocytes, and many studies have shown that delayed reconstitution of B lymphocytes contributed to chronic graft-versus-host disease (cGVHD). This study assessed the predictive value of FLC levels in serum collected early after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for cGVHD.

METHODS

Sixty-two patients who had undergone allo-HSCT were retrospectively reviewed. The correlations between the FLC levels and the development of cGVHD were explored.

RESULTS

Of the 62 patients, 33 cases developed cGVHD, with the prevalence of 53.2%. With Seattle classification, 19 cases had limited cGVHD while 14 cases contracted extensive cGVHD. While with NIH classification, 17 cases had mild cGVHD, 6 cases moderate cGVHD, and 10 cases severe cGVHD. Multivariant statistical analysis showed that the FLC levels were not associated with all severities of cGVHD but were correlated with the development of extensive or moderate to severe cGVHD (P = .01 and .038, respectively).

CONCLUSIONS

Serum FLC levels early after HSCT may reflect the functional state of B-cell reconstitution. Patients with low serum FLC Level early post-allo-HSCT tend to develop extensive cGVHD or moderate to severe cGVHD.

摘要

目的

血清游离轻链(FLC)水平与B淋巴细胞的功能状态密切相关,许多研究表明B淋巴细胞重建延迟会导致慢性移植物抗宿主病(cGVHD)。本研究评估了异基因造血干细胞移植(allo-HSCT)后早期采集的血清中FLC水平对cGVHD的预测价值。

方法

回顾性分析62例行allo-HSCT的患者。探讨FLC水平与cGVHD发生之间的相关性。

结果

62例患者中,33例发生cGVHD,发生率为53.2%。根据西雅图分类,19例为局限性cGVHD,14例为广泛性cGVHD。根据美国国立卫生研究院(NIH)分类,17例为轻度cGVHD,6例为中度cGVHD,10例为重度cGVHD。多变量统计分析显示,FLC水平与所有严重程度的cGVHD均无相关性,但与广泛性或中度至重度cGVHD的发生相关(P分别为0.01和0.038)。

结论

HSCT后早期血清FLC水平可能反映B细胞重建的功能状态。allo-HSCT后早期血清FLC水平低的患者易发生广泛性cGVHD或中度至重度cGVHD。

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